Organization
IKONMED CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANGEL M SANTIAGO (PRESIDENT)
(787) 458-6569
Entity
Organization
Contact information
Practice address
1000 POST AND PADDOCK ST STE 409, GRAND PRAIRIE, TX 75050-1143
(787) 673-3830
Mailing address
1000 POST AND PADDOCK ST STE 409, GRAND PRAIRIE, TX 75050-1143
(787) 673-3830
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TX
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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