Healthcare Provider Details
I. General information
NPI: 1306993605
Provider Name (Legal Business Name): METROPLEX DIAGNOSITCS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 WYNNEWOOD VILLAGE
DALLAS TX
75224
US
IV. Provider business mailing address
PO BOX 671175
DALLAS TX
75267-1175
US
V. Phone/Fax
- Phone: 214-378-4499
- Fax: 214-948-6576
- Phone: 214-378-4499
- Fax: 214-948-6576
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
THOMAS
RHUDY
Title or Position: CHIEF OF STAFF
Credential: DC
Phone: 214-378-4499