Provider Demographics
NPI:1831550508
Name:METRO SE HC LLC
Entity type:Organization
Organization Name:METRO SE HC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-327-1700
Mailing Address - Street 1:7501 ESTERS BLVD.
Mailing Address - Street 2:STE 110
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063
Mailing Address - Country:US
Mailing Address - Phone:214-327-1700
Mailing Address - Fax:888-711-0881
Practice Address - Street 1:5959 WEST LOOP SOUTH
Practice Address - Street 2:STE 175
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:281-557-0102
Practice Address - Fax:281-557-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67-3139OtherMEDICARE ID #
TX67-3139Medicare UPIN