Organization
METROPLEX MEDLINK PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES E MATHIS III M.D. (PRESIDENT)
(972) 223-2760
Entity
Organization
Contact information
Practice address
2000 NORTH OLD HICKORY TRAIL, DESOTO, TX 75115-7809
(972) 223-2760
Mailing address
PO BOX 7736, DALLAS, TX 75209-0736
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
E6497
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK7013
RR MEDICARE GROUP NUMBER
TX
Enumeration date
04/02/2007
Last updated
03/14/2008
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