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DR. OCTAVIO LICON MD NPI 1629057179


NPI Information

NPI: 1629057179
Provider Name: DR. OCTAVIO LICON, MD
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Individual
Address:
10410 VISTA DEL SOL DR
EL PASO, TX
ZIP 79925
Phone: (915) 592-3323
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DR. Octavio Licon, MD is an orthopaedic surgery in El Paso, TX. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. DR. Octavio Licon, MD NPI is 1629057179. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10410 VISTA DEL SOL DR
EL PASO, TX
ZIP 79925-919
Phone: (915) 592-3323
Fax: (915) 593-8571

The enumeration date for this NPI number is 1/12/2006 and was last updated on 4/6/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic Surgery86-269NEW MEXICONo
2207XS0106XOrthopaedic SurgeryHand SurgeryF2773TEXASNo
3207XS0106XOrthopaedic SurgeryHand Surgery86-269NEW MEXICONo
4207X00000XOrthopaedic SurgeryF2773TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P000EN585MEDICAIDTEXAS
200EN58MEDICARE ID-TYPE UNSPECIFIEDTEXAS
30000Y3758MEDICAIDNEW MEXICO
4B24377MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.