Organization
METROPLEX HEMATOLOGY ONCOLOGY ASSOCIATES
Active
Parent organization
METROPLEX HEMATOLOGY ONCOLOGY ASSOCIATES
Other names
Metro Hemo Onc
Organization subpart
Yes
Provider details
NPI number
Legal business name
METROPLEX HEMATOLOGY ONCOLOGY ASSOCIATES
Authorized official
ALFRED DISTEFANO MD (MANAGING PARTNER)
(817) 261-4906
Entity
Organization
Contact information
Practice address
906 W RANDOL MILL RD, ARLINGTON, TX 76012-2510
(817) 261-4906
(817) 543-4675
Mailing address
PO BOX 974315, DALLAS, TX 75397-4315
(817) 261-4906
(817) 543-4675
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019CP
BLUECROSSBLUESHIELD OF TX
TX
05
—
121904002
—
TX
01
—
CC9402
RAILROAD MEDICARE PTAN
—
Enumeration date
08/16/2005
Last updated
04/27/2009
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