Provider Demographics
NPI:1962523852
Name:ID SPECIALISTS, P.A.
Entity type:Organization
Organization Name:ID SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANGOLEE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ARORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-566-5560
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:SUITE B-412
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2505
Mailing Address - Country:US
Mailing Address - Phone:972-566-5560
Mailing Address - Fax:972-566-5562
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE B-412
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-661-5550
Practice Address - Fax:972-991-3258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079913201Medicaid
TX0076EVOtherBLUE CROSS BLUE SHIELD