| NPI | 1689842445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A ICETON Medical Doctor 409-983-5178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX H6857) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2023-03-07 |