Provider Demographics
NPI:1326720160
Name:IDOCSWEB CORP
Entity Type:Organization
Organization Name:IDOCSWEB CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BHARATH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYASAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:800-990-7993
Mailing Address - Street 1:5465 LEGACY DR STE 650
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4171
Mailing Address - Country:US
Mailing Address - Phone:800-990-7993
Mailing Address - Fax:
Practice Address - Street 1:5465 LEGACY DR STE 650
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4171
Practice Address - Country:US
Practice Address - Phone:800-990-7993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty