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Organization
ICONIC USA HEALTHCARE LLC
Active
Organization
ICONIC USA HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAURA STANSBERRY (PARTNER)
(832) 282-7511
Entity
Organization
Contact information
Practice address
6630 HORNWOOD DR, HOUSTON, TX 77074-5010
(832) 497-5770
(832) 497-5771
Mailing address
6630 HORNWOOD DR, HOUSTON, TX 77074-5010
(832) 497-5770
(888) 294-7945
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/06/2013
Last updated
12/23/2013
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