EDWARD EARL ICAZA

FORT WORTH, TX
NPI1134121940
Professional NameEDWARD E ICAZA
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084N0400X Psychiatry & Neurology, Neurology
(Licence: TX  K9809)
Additional Taxonomies2084N0400X Psychiatry & Neurology, Neurology
(Licence: OK  26567)
Enumeration Date2005-08-11
Last Update Date2024-11-13
Business Address
EDWARD EARL ICAZA MD
5801 OAKBEND TRL STE 270
FORT WORTH, TX 76132-3922
Phone number: 817-615-9496
Mailing Address
EDWARD EARL ICAZA MD
5801 OAKBEND TRL STE 270
FORT WORTH, TX 76132-3922
Phone number: 817-615-9496