Iconic USA Healthcare LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ICONIC USA HEALTHCARE LLC

Practice address

6630 Hornwood Dr
Houston, TX 77074-5010

Phone

(832) 497-5770

Fax

(832) 497-5771

NPI assigned

Aug 6, 2013

Organization subpart

No

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

Authorized official

Name

Taura Stansberry

Title

Partner

Phone

(832) 282-7511

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387756800000",
    "number": "1205268794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 HORNWOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770745010",
            "telephone_number": "832-497-5770",
            "fax_number": "888-294-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 HORNWOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770745010",
            "telephone_number": "832-497-5770",
            "fax_number": "832-497-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICONIC USA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-06",
        "last_updated": "2013-12-23",
        "status": "A",
        "authorized_official_last_name": "STANSBERRY",
        "authorized_official_first_name": "TAURA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "832-282-7511"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; 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.