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Contact Information

ICONIQ SPINE & ORTHOPAEDIC CENTER PLLC
4441 W AIRPORT FWY STE 215
IRVING, TX75062-5959
 Phone: 469-444-7246
 Fax: 469-440-2667
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for ICONIQ SPINE ORTHOPAEDIC CENTER PLLC · (Female)

NPI # 1578279238
Status Active
Credentials
Entity Individual
Enumeration date 01/26/2023
Last updated 05/09/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX Other 1780936971 CASH
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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