Individual
JOHN A. ICETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2927 PARK PLAZA LN, PORT ARTHUR, TX 77642-5516
(409) 983-5178
(409) 983-6078
Mailing address
2927 PARK PLAZA LN, PORT ARTHUR, TX 77642-5516
(409) 983-5178
(409) 983-6078
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H6857
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H6857
MEDICAL LICENSE
TX
Enumeration date
07/29/2005
Last updated
03/07/2023
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