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General NPI Number Information
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NPI Number | 1497554810
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Entity Type | Organization
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Legal Business Name | DOCCA MEDICAL PA
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2304 HIGHWAY 121
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City | BEDFORD
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State | TX
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Zip | 76021-5985
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Country | US
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Telephone | 817-684-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 829 GIVERNY LN
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City | SOUTHLAKE
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State | TX
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Zip | 76092-1322
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Country | US
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Telephone | 646-796-7369
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAMA KRISHNA VENKATA DOCCA
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Credential | MD
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Telephone | 646-796-7369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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