Metroplex Dermatology Aesthetics, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

METROPLEX DERMATOLOGY AESTHETICS, LLC

Practice address

300 W Arbrook Blvd Ste D
Arlington, TX 76014-3105

Phone

(817) 704-4777

Fax

(817) 701-2323

NPI assigned

Oct 12, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terri J Avery

Title

Credentialing

Phone

(817) 704-4777

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539302400000",
    "number": "1619442902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W ARBROOK BLVD STE D",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760143105",
            "telephone_number": "817-704-4777",
            "fax_number": "817-701-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W ARBROOK BLVD STE D",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760143105",
            "telephone_number": "817-704-4777",
            "fax_number": "817-701-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPLEX DERMATOLOGY AESTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-12",
        "last_updated": "2018-10-12",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "817-704-4777"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8CF563",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monique Metcalf
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• Metro Visiting Physician PLLC
• Metrocare Services
• Metroplex Dermatology, PLLC
• Metroplex Ekg
• Metroplex Hematology Oncology Associates
• Metroplex Hematology Oncology Associates
• Metroplex Hematology Oncology Associates

• Dermatology Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.