Octavio Licon, M.D. P.a.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

F2773 Issued in TX

Legal business name

OCTAVIO LICON, M.D. P.A.

Practice address

10410 Vista del Sol Dr.
El Paso, TX 79925

Phone

(915) 592-3323

Fax

(915) 593-8571

NPI assigned

Jun 3, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Octavio Licon, M.D.

Title

President

Phone

(915) 592-3323

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275523200000",
    "number": "1134449960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10410 VISTA DEL SOL DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257919",
            "telephone_number": "915-592-3323",
            "fax_number": "915-593-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10410 VISTA DEL SOL DR.",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79925",
            "telephone_number": "915-592-3323",
            "fax_number": "915-593-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCTAVIO LICON, M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A",
        "authorized_official_last_name": "LICON",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "915-592-3323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "F2773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Ocon, APRN-CNP
• Ocotillo Wellness PLLC
• Octavian Antohi, MD PA
• Octavias Group LLC
• Octavio E. Gutierrez, M.D., P.a.
• Ocular Oncology and Medical Retina P.a.
• Ocular Services of Texas, Inc.
• Ocular Services of Texas, Inc.
• Odin Emergency Physicians
• Pamela Y. Odom, LPC

• Orthopaedic Surgery Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.