# IKONMED CORP.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699059691
- **Authorized official:** MR. ANGEL M SANTIAGO (PRESIDENT)
- **Authorized official phone:** (787) 458-6569

## Contact information

- **Practice address:** 1000 POST AND PADDOCK ST STE 409, GRAND PRAIRIE, TX 75050-1143
- **Practice address phone:** (787) 673-3830
- **Mailing address:** 1000 POST AND PADDOCK ST STE 409, GRAND PRAIRIE, TX 75050-1143
- **Mailing address phone:** (787) 673-3830

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | TX | Yes |

## Other

- **Enumeration date:** 10/10/2011
- **Last updated:** 10/10/2011