MEDICARE: MULTIPLEX HEALTHCARE SERVICES INC

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
1	293D00000X	Physiological Laboratory	45D0958950	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	104988100	OTHER	TX	FIRSTCARE PROVIDER NUMBER
3	459848	OTHER	TX	BCBS PROV NUMBER

General Provider Information

NPI Number	:	1891792321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULTIPLEX HEALTHCARE SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 289
Second Line	:
City	:	MEXIA
State	:	TX
Zip	:	76667-0289
Country	:	US
Telephone Number	:	254-562-3803
Fax Number	:	254-562-2372

Provider Business Practice Location Address
First Line	:	837 TEHUACANA HWY
Second Line	:
City	:	MEXIA
State	:	TX
Zip	:	76667-0837
Country	:	US
Telephone Number	:	254-562-3803
Fax Number	:	254-562-2372

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. WILLIAM H WRAGGE
Credential	:	RRT
Telephone Number	:	254-562-3803

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	06/16/2010

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Directions to “MULTIPLEX HEALTHCARE SERVICES INC ” Practice Location

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