Healthcare Provider Details

I. General information

NPI: 1952348823
Provider Name (Legal Business Name): DANIEL NEIL METZGER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 HOSPITAL DR # 140
CORSICANA TX
75110-2415
US

IV. Provider business mailing address

2815 S HAMPTON RD
DALLAS TX
75224-2329
US

V. Phone/Fax

Practice location:
  • Phone: 903-201-6405
  • Fax:
Mailing address:
  • Phone: 214-330-0137
  • Fax: 214-333-7343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH6432
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: