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DENNIS A ICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11 MEDICAL DRIVE, AMARILLO, TX 79106-1781
(806) 353-6400
Mailing address
11 MEDICAL DRIVE, AMARILLO, TX 79106-1781
(806) 353-6400

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
K0068
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
115738101
SOUTHWEST LIFE & HEALTH
TX
05
148784502
TX
01
8Z0461
BCBS
TX
01
P00045527
MEDICARE RAILROAD
TX
Enumeration date
08/21/2006
Last updated
10/26/2007
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