Provider Demographics
NPI:1598401374
Name:METROPOLITAN MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:METROPOLITAN MEDICAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARJON
Authorized Official - Middle Name:
Authorized Official - Last Name:MONFARED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-518-2371
Mailing Address - Street 1:3005 WEST LOOP S STE 240
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-6116
Mailing Address - Country:US
Mailing Address - Phone:713-468-4247
Mailing Address - Fax:833-637-1605
Practice Address - Street 1:3005 WEST LOOP S STE 240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6116
Practice Address - Country:US
Practice Address - Phone:713-468-4247
Practice Address - Fax:833-637-1605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty