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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. OCTAVIO LICON, MD

Active Sole Proprietor

DR. OCTAVIO LICON, MD is a Orthopaedic Surgery healthcare provider located in EL PASO, Texas. NPI 1629057179 is currently active in the NPPES registry. Verify at CMS.

Orthopaedic Surgery · EL PASO, TX

Registration Details

NPI Number
1629057179
Provider Type
Individual
Gender
Male
NPI Issued
Jan 12, 2006 (20.403217608245 yrs)
Last Updated
Apr 6, 2010
Licenses
86-269 (NM)
F2773 (TX)
F2773 (TX)
86-269 (NM)
Sole Proprietor
Yes

Practice Information

Address
10410 VISTA DEL SOL DR
EL PASO, TX, 799257919
Browse TX providers · Browse ZIP 79925
Phone
9155923323
Fax
9155938571
Primary Specialty
Orthopaedic Surgery
207X00000X
Additional Specialty
Orthopaedic Surgery

Other Orthopaedic Surgery Providers in EL PASO, TX

Name Credential NPI
DR. JACOB SAMUEL HEYDEMANN M.D. 1548263635
DR. THOMAS E ALOST M.D. 1508864182
DR. ALVARO A HERNANDEZ M.D. 1013915503
MICHAEL A FALLON MD 1457341810
MR. RANDY J POLLET MD 1437131463
JOHN S JACKSON DO 1689654600
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.