Healthcare Provider Details

I. General information

NPI: 1639171093
Provider Name (Legal Business Name): METROPLEX HEMATOLOGY ONCOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 W RANDOL MILL RD ARLINGTON CANCER CENTER
ARLINGTON TX
76012-2510
US

IV. Provider business mailing address

PO BOX 974315 METROPLEX MEDICAL LAB
DALLAS TX
75397-4315
US

V. Phone/Fax

Practice location:
  • Phone: 817-261-4906
  • Fax: 817-261-5837
Mailing address:
  • Phone: 817-261-4906
  • Fax: 817-543-4675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: KAREL ADRIAAN DICKE
Title or Position: CEO & MANAGING PARTNER
Credential: MD PHD
Phone: 817-261-4906