Provider Demographics
NPI:1568709111
Name:METROPLEX FIRST SURGICAL PLLC
Entity Type:Organization
Organization Name:METROPLEX FIRST SURGICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-768-5011
Mailing Address - Street 1:PO BOX 1138
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-0018
Mailing Address - Country:US
Mailing Address - Phone:972-768-5011
Mailing Address - Fax:888-770-6360
Practice Address - Street 1:5550 LBJ FWY
Practice Address - Street 2:SUITE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6217
Practice Address - Country:US
Practice Address - Phone:972-768-5011
Practice Address - Fax:888-770-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4104208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty