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General NPI Number Information
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NPI Number | 1932277852
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Entity Type | Organization
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Legal Business Name | METROPLEX NEMATOLOGY ONCOLOGY ASSOCIATES
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | IMMUNODIAGNOSTIC LABS OF TX INC ARLINGTON CANCER CENTER 900 W RANDOL MILL RD #102
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City | ARLINGTON
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State | TX
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Zip | 76012-2510
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Country | US
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Telephone | 817-261-4906
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Fax | 817-261-5837
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Provider Business Mailing Address
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Address Line | ARLINGTON CANCER CENTER 906 W RANDOL MILL RD
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City | ARLINGTON
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State | TX
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Zip | 76012-2510
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Country | US
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Telephone | 817-261-4906
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Fax | 817-261-5837
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Authorized Official
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Title or Position | CEO MANAGING PARTNER
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Name | KAREL ADRIAAN DICKE
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Credential | MD PHD
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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