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General NPI Number Information
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NPI Number | 1457353815
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Entity Type | Organization
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Legal Business Name | METROPLEX HEMATOLOGY ONCOLOGY ASSOCIATES
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2800 E STATE HIGHWAY 114 ARLINGTON CANCER CENTER AT TROPHY CLUB
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City | TROPHY CLUB
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State | TX
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Zip | 76262-5304
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Country | US
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Telephone | 817-261-4906
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Fax | 817-543-4675
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Provider Business Mailing Address
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Address Line | PO BOX 974315
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City | DALLAS
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State | TX
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Zip | 75397-4315
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Country | US
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Telephone | 817-261-4906
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Fax | 817-543-4675
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | ALFRED DISTEFANO
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Credential | MD
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Telephone | 817-261-4906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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