Provider Demographics
NPI:1194345132
Name:METROPLEX WELLNESS, LLC
Entity type:Organization
Organization Name:METROPLEX WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:THWAITES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-205-2661
Mailing Address - Street 1:950 E STATE HIGHWAY 114 STE 160
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5261
Mailing Address - Country:US
Mailing Address - Phone:214-205-2661
Mailing Address - Fax:214-481-1240
Practice Address - Street 1:950 E STATE HIGHWAY 114 STE 160
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-5261
Practice Address - Country:US
Practice Address - Phone:214-205-2661
Practice Address - Fax:214-481-1240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty