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NPI Code Detail

MEDICARE: IDCARE, PLLC

MEDICARE: IDCARE, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease Physician

General Provider Information

NPI Number : 1093123085
Entity Type Code : Organization
Provider Name (Legal Business Name) : IDCARE, PLLC
Provider Business Mailing Address
First Line : PO BOX 251382
Second Line :
City : PLANO
State : TX
Zip : 75025-1382
Country : US
Telephone Number : 469-408-9558
Fax Number : 888-393-5922
Provider Business Practice Location Address
First Line : 4100 W 15TH ST STE 110
Second Line :
City : PLANO
State : TX
Zip : 75093-5826
Country : US
Telephone Number : 469-408-9558
Fax Number : 888-393-5922
Authorized Official
Title or Position : CEO
Name : SRIVALLI ADARI
Credential : MD
Telephone Number : 469-408-2530
Provider Enumeration Date : 07/23/2014
Last Update Date : 06/09/2020

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Directions to “IDCARE, PLLC ” Practice Location

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