Provider Demographics
NPI:1841862950
Name:ICU DYNAMICS PLLC
Entity type:Organization
Organization Name:ICU DYNAMICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGORORDO ARZAMENDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-450-3093
Mailing Address - Street 1:2206 SABINAL ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7478
Mailing Address - Country:US
Mailing Address - Phone:956-450-3093
Mailing Address - Fax:956-631-9822
Practice Address - Street 1:1112 E GRIFFIN PKWY STE D
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2408
Practice Address - Country:US
Practice Address - Phone:956-450-3093
Practice Address - Fax:956-631-9822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty