Provider Demographics
NPI:1699783464
Name:METROPLEX IMAGING LP
Entity type:Organization
Organization Name:METROPLEX IMAGING LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-563-3342
Mailing Address - Street 1:17950 PRESTON ROAD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5793
Mailing Address - Country:US
Mailing Address - Phone:214-253-0390
Mailing Address - Fax:214-253-0393
Practice Address - Street 1:17950 PRESTON ROAD
Practice Address - Street 2:SUITE 120
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5793
Practice Address - Country:US
Practice Address - Phone:214-253-0390
Practice Address - Fax:214-253-0393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTNUXDMedicare ID - Type Unspecified