Provider Demographics
NPI:1174610547
Name:METROPLEX EKG
Entity type:Organization
Organization Name:METROPLEX EKG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:KATRINIA
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RCP,CRT
Authorized Official - Phone:817-775-8004
Mailing Address - Street 1:5603 COLEBROOK TRL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-0507
Mailing Address - Country:US
Mailing Address - Phone:817-775-8004
Mailing Address - Fax:
Practice Address - Street 1:5603 COLEBROOK TRL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-0507
Practice Address - Country:US
Practice Address - Phone:817-775-8004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59126227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Single Specialty