Licon, Octavio
Licon, Octavio is an sole proprietor health care provider with primary practice located at 10410 Vista Del Sol Dr , El Paso TX 79925-7919. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Hand Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Licon, Octavio can be contacted via phone (915) 592-3323.Contact Information
Primary practice address
10410 Vista Del Sol Dr
El Paso TX 79925-7919
Phone: (915) 592-3323
Fax: (915) 593-8571
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 86-269 | New Mexico |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | F2773 | Texas |
| Allopathic & Osteopathic Physicians / Hand Surgery | 207XS0106X | F2773 | Texas |
| Allopathic & Osteopathic Physicians / Hand Surgery | 207XS0106X | 86-269 | New Mexico |
Profile Details
| NPI number | 1629057179 |
|---|---|
| LBN Legal business name | Licon, Octavio |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 12th, 2006 |
| Last updated | Apr 6th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629057179 | NPPES |
| Texas | MEDICAID | P000EN585 | |
| Texas | MEDICAID | 0000Y3758 |
Popular Providers
-
Westbrook, Richard S
4646 N Mesa St , El Paso TX 79912-6104 -
Bagg, Raymond J.
4801 Alberta Ave , El Paso TX 79905 -
King, Barry G
1720 Murchison Dr , El Paso TX 79902 -
Orr, Justin Dennis
4801 Alberta Ave , El Paso TX 79905-2707 -
Mansfield, David J
1720 Murchison , El Paso TX 79902 -
Pacheco-Serrant, Helson
1700 N Oregon St Ste 660, El Paso TX 79902-3584 -
Pirela-Cruz, Miguel A.
1540 N Zaragoza Rd , El Paso TX 79936-7905 -
Vande Lune, Daniel Wayne
1400 George Dieter Dr Suite 100, El Paso TX 79936-7653