Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1629057179 Individual Practitioner Male Practitioner

Dr. Octavio Licon , MD

Orthopaedic Surgery • El Paso, TX

Professional Overview & Biography Verified Profile Summary

Dr. Octavio Licon, MD is a registered healthcare professional specializing in Orthopaedic Surgery in El Paso, TX. Practice services are available at 10410 VISTA DEL SOL DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

10410 Vista Del Sol Dr

El Paso, TX 799257919

Telephone 9155923323
Fax 9155938571
Associated Practice Facility / Clinic
🏢 Carlos Gonzalez Facility NPI 1619220928

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in El Paso, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 28.0 Yrs
State Avg: 25.4 Yrs
Regional Practice Density
52 Specialists

Practicing in El Paso, TX (1627 Statewide)

Telehealth Adoption Rate
1.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License TX F2773

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Orthopaedic Surgery

NUCC Taxonomy Code: 207X00000X

State License NM 86-269

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Orthopaedic Surgery - Hand Surgery

NUCC Taxonomy Code: 207XS0106X

State License TX F2773

An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

Orthopaedic Surgery - Hand Surgery

NUCC Taxonomy Code: 207XS0106X

State License NM 86-269

An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
P000EN585 (TX)
Medicaid State Provider ID
0000Y3758 (NM)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Sara Gonzalez , PT, DPT

Physical Medicine & Rehabilitation

NPI 1164978185

Physical Therapist, Doctor of Physical Therapy

Dr. Carlos Gonzalez , MD

Orthopaedic Surgery

NPI 1336305663

Doctor of Medicine (M.D.)

Dr. Miguel Pirela-Cruz , MD

Orthopaedic Surgery - Hand Surgery

NPI 1386604767

Doctor of Medicine (M.D.)

NPI 1417796509

Physical Therapist, Doctor of Physical Therapy

Guadalupe Armenta Carrasco , APRN-CNP

Nurse Practitioner - Family

NPI 1780392365

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active April 06, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location April 06, 2010

Registered at 10410 VISTA DEL SOL DR, EL PASO, TX 799257919 (Tel: 9155923323)

📍
Updated Business Mailing Address April 06, 2010

Registered at 10410 VISTA DEL SOL DR, EL PASO, TX 799257919 (Tel: 9155923323)

👤
Provider Name / Credentials Updated April 06, 2010

Recorded as OCTAVIO LICON, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2010

Orthopaedic Surgery (License #F2773 in TX)

🟢
Initial NPI Registration & Enumeration January 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1629057179
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 12, 2006
Last Update: April 06, 2010
Sole Proprietor: Yes

Mailing Address

10410 Vista Del Sol Dr

El Paso, TX 799257919

Phone: 9155923323

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.