Provider Demographics
NPI:1891792321
Name:MULTIPLEX HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:MULTIPLEX HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:WRAGGE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:254-562-3803
Mailing Address - Street 1:PO BOX 289
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-0289
Mailing Address - Country:US
Mailing Address - Phone:254-562-3803
Mailing Address - Fax:254-562-2372
Practice Address - Street 1:837 TEHUACANA HWY
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-0837
Practice Address - Country:US
Practice Address - Phone:254-562-3803
Practice Address - Fax:254-562-2372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D0958950293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126009301Medicaid
TX104988100OtherFIRSTCARE PROVIDER NUMBER
TX459848OtherBCBS PROV NUMBER
TX=========OtherCOMMERICIAL
TX=========OtherCOMMERICIAL
TX459848OtherBCBS PROV NUMBER
TX630000539Medicare ID - Type UnspecifiedRR MEDICARE PROV NUMBER,2