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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

NPI # 1578279238
LBN Legal business name ICONIQ SPINE & ORTHOPAEDIC CENTER PLLC
Authorized official TRUNG HA - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 01/26/2023
Last updated 05/09/2024 - About 2 years ago
Identifiers
TX Other 1780936971 CASH
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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