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General NPI Number Information
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NPI Number | 1972110971
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Entity Type | Organization
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Legal Business Name | METROPLEX SURGICAL INSTITUTE PLLC
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Dates
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Enumeration Date | 09/24/2020
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 2937 LAGO VISTA LN
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City | ROCKWALL
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State | TX
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Zip | 75032-5466
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Country | US
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Telephone | 972-439-3753
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Fax | 972-439-3754
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Provider Business Mailing Address
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Address Line | 2937 LAGO VISTA LN
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City | ROCKWALL
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State | TX
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Zip | 75032-5466
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Country | US
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Telephone | 972-439-3753
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Fax | 972-439-3754
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | ANGELA MAGGARD
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Credential |
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Telephone | 972-439-3753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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