Healthcare Provider Details

I. General information

NPI: 1033085253
Provider Name (Legal Business Name): BRICE CHRISTIAN HOUNDEKON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 16TH AVE SW APT 104
CEDAR RAPIDS IA
52404-1260
US

IV. Provider business mailing address

5200 16TH AVE SW APT 104
CEDAR RAPIDS IA
52404-1260
US

V. Phone/Fax

Practice location:
  • Phone: 309-281-8402
  • Fax:
Mailing address:
  • Phone: 309-281-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number151AM6122
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: