Provider Demographics
NPI:1144567652
Name:METROPLEX RADIOLOGY PLLC
Entity Type:Organization
Organization Name:METROPLEX RADIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-782-9222
Mailing Address - Street 1:908 BROWNFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4359
Mailing Address - Country:US
Mailing Address - Phone:214-782-9222
Mailing Address - Fax:214-782-9333
Practice Address - Street 1:908 BROWNFIELD DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4359
Practice Address - Country:US
Practice Address - Phone:214-782-9222
Practice Address - Fax:214-782-9333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-04
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE120652085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0550863Medicaid
B52707Medicare UPIN
NE272725Medicare PIN