| Shanaz Ikonne, Pllc | |
|
1021 Ranch Road 620 S Ste B Lakeway TX 78734-5611 | |
| (469) 626-9085 | |
| Not Available |
| Full Name | Shanaz Ikonne, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1021 Ranch Road 620 S Ste B, Lakeway, Texas |
| Authorized Official Name and Position | Shanaz Sara Ikonne (OWNER) |
| Authorized Official Contact | 4696269085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shanaz Ikonne, Pllc 7500 S Ih 35 Unit 523 Austin TX 78745-6626 Ph: (469) 626-9085 | Shanaz Ikonne, Pllc 1021 Ranch Road 620 S Ste B Lakeway TX 78734-5611 Ph: (469) 626-9085 |
| NPI Number | 1093230823 |
|---|---|
| Provider Enumeration Date | 08/14/2017 |
| Last Update Date | 08/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093230823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 73271 (Texas) | Primary |
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