Provider Demographics
NPI:1982249405
Name:IKON PAIN MANAGEMENT CONSULTANTS PLLC
Entity Type:Organization
Organization Name:IKON PAIN MANAGEMENT CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SPIRO
Authorized Official - Middle Name:ADEL
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-964-0641
Mailing Address - Street 1:430 HAWKINS RUN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-6660
Mailing Address - Country:US
Mailing Address - Phone:469-964-0641
Mailing Address - Fax:833-941-2603
Practice Address - Street 1:430 HAWKINS RUN RD STE 1
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-6660
Practice Address - Country:US
Practice Address - Phone:469-964-0641
Practice Address - Fax:833-941-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain