MEDICARE: METROPLEX PATHOLOGY ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942223029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METROPLEX PATHOLOGY ASSOCIATES

Provider Business Mailing Address
First Line	:	6655 NORTH MACARTHUR BLVD
Second Line	:	ATTN: PROVIDER ENROLLMENT
City	:	IRVING
State	:	TX
Zip	:	75039-2443
Country	:	US
Telephone Number	:	214-596-7031
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 S FREEPORT PKWY
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-4435
Country	:	US
Telephone Number	:	800-979-8292
Fax Number	:

Authorized Official
Title or Position	:	VP. GENERAL MANAGER
Name	:	RAYMOND CHRISTOPHER WICKER
Credential	:
Telephone Number	:	678-477-4402

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	02/20/2025

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Directions to “METROPLEX PATHOLOGY ASSOCIATES ” Practice Location

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