{"npi":"1033295142","type":"NPI-2","status":"active","name":{"display":"Edward E Icaza MD PA","other":[],"organization_name":"EDWARD E ICAZA MD PA","authorised_official":"Edward Icaza"},"specialty":{"primary_taxonomy":"2084N0400X","primary_taxonomy_description":"Neurology","slug":"neurology","schema_org_specialty":"Neurologic","all":[{"code":"2084N0400X","description":"Neurology","primary":false,"state":null,"license":null},{"code":"2084N0400X","description":"Neurology","primary":true,"state":"TX","license":"K9809"}]},"addresses":[{"purpose":"LOCATION","street_1":"5801 OAKBEND TRL STE 270","city":"FORT WORTH","state":"TX","postal_code":"761323922","country_code":"US","phone":"8176159496","fax":"8555764158"},{"purpose":"MAILING","street_1":"5801 OAKBEND TRL STE 270","city":"FORT WORTH","state":"TX","postal_code":"761323922","country_code":"US","phone":"8176159496"}],"license":{"state":"TX","number":"K9809"},"identifiers":[{"type_code":"01","label":"Other","value":"0072JA","state":"TX","issuer":"BCBS"},{"type_code":"01","label":"Other","value":"K9809","state":"TX","issuer":"NEUROLOGIST"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20060424000511","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"TX","pac_id":"2163432964"}]},"enumeration_date":"2006-10-31","last_updated":"2024-11-13","_meta":{"source":"NPPES","snapshot_date":"2024-11-13","doc_url":"https://findmynpi.com/api"}}