Organization
ICONIQ SPINE & ORTHOPAEDIC CENTER PLLC
Active
Other names
HOLISTIQ SPINE & ORTHOPAEDIC CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
TRUNG VAN HA (AUTHORIZED OFFICIAL)
(469) 444-7246
Entity
Organization
Contact information
Practice address
5655 W SPRING CREEK PKWY STE 115, PLANO, TX 75024-4175
(469) 444-7246
Mailing address
4441 W AIRPORT FWY STE 215, IRVING, TX 75062-5959
(469) 444-7246
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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