Provider Demographics
NPI:1366639742
Name:METROPLEX PEDIATRICS
Entity type:Organization
Organization Name:METROPLEX PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:ABIMBOLA
Authorized Official - Middle Name:O
Authorized Official - Last Name:DOSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-922-0800
Mailing Address - Street 1:6905 DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-4003
Mailing Address - Country:US
Mailing Address - Phone:817-922-0800
Mailing Address - Fax:817-922-0805
Practice Address - Street 1:6905 DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4003
Practice Address - Country:US
Practice Address - Phone:817-922-0800
Practice Address - Fax:817-922-0805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2024-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5093208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty