| Idocsweb LLC | |
|
5700 Granite Pkwy Ste 200 Plano TX 75024-6623 | |
| (636) 221-2740 | |
| Not Available |
| Full Name | Idocsweb LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 5700 Granite Pkwy Ste 200, Plano, Texas |
| Authorized Official Name and Position | Anton Lyubomirov Georgiev (CMO) |
| Authorized Official Contact | 6362212740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Idocsweb LLC 5700 Granite Pkwy Ste 200 Plano TX 75024-6623 | Idocsweb LLC 5700 Granite Pkwy Ste 200 Plano TX 75024-6623 Ph: (636) 221-2740 |
| NPI Number | 1386273787 |
|---|---|
| Provider Enumeration Date | 04/07/2020 |
| Last Update Date | 06/22/2020 |
| Certification Date | 06/22/2020 |
| Medicare PECOS PAC ID | 5092137679 |
|---|---|
| Medicare Enrollment ID | O20200909001844 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386273787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Omar a Al-abboud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740693449 PECOS PAC ID: 9638471493 Enrollment ID: I20200922001035 |
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