Organization
METROPLEX DERMATOLOGY AESTHETICS, LLC
Active
Organization
METROPLEX DERMATOLOGY AESTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI J AVERY (CREDENTIALING)
(817) 704-4777
Entity
Organization
Contact information
Practice address
300 W ARBROOK BLVD STE D, ARLINGTON, TX 76014-3105
(817) 704-4777
(817) 701-2323
Mailing address
300 W ARBROOK BLVD STE D, ARLINGTON, TX 76014-3105
(817) 704-4777
(817) 701-2323
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8CF563
BCBS OF TEXAS
TX
Enumeration date
10/12/2018
Last updated
10/12/2018
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