Irene Rae Willingham, M.D.

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

H0463 Issued in TX

Practice address

4809 Cole Ave
Suite 110
Dallas, TX 75205-3578

Phone

(214) 526-8600

Fax

(214) 443-3897

NPI assigned

Jun 27, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthtexas Provider Network-Neurosurgical Associates, LLP

  • Neurological Surgery Physician
  • Dallas, TX
  • NPI 1437154077
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239408000000",
    "number": "1376570101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4809 COLE AVE",
            "address_2": "SUITE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053578",
            "telephone_number": "214-526-8600",
            "fax_number": "214-443-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 COLE AVE",
            "address_2": "SUITE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053578",
            "telephone_number": "214-526-8600",
            "fax_number": "214-443-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLINGHAM",
        "first_name": "IRENE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2009-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "TX",
            "license": "H0463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Howard Williamson, MS, LPC, NCC, LCDC
• Kandace L Williamson, LMFT ASSOCIATE
• Shaniqua Juanita Williamson, PA-C
• Susan W Williamson, MD
• James Willig
• Byrd Cicero Willis Pineda, MD, MSC
• Ann Butler Willis, M.S., CCC-SLP
• Ardelia Willis
• Brandon Willis
• Brittany Louise Willis, CRNA

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.