Provider Demographics
NPI:1326505637
Name:METROPLEX MEDICAL CENTRE - FORT WORTH
Entity Type:Organization
Organization Name:METROPLEX MEDICAL CENTRE - FORT WORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SNEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-580-7277
Mailing Address - Street 1:700 N PEARL ST STE N510
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2863
Mailing Address - Country:US
Mailing Address - Phone:214-580-7277
Mailing Address - Fax:
Practice Address - Street 1:201 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-7206
Practice Address - Country:US
Practice Address - Phone:214-580-7277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1043627870OtherGROUP NPI NUMBER