Basic Information
| Provider Information | |||||||||
| NPI: | 1851795157 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | METRO TREATMENT OF TEXAS, LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 E SESAME SQUARE | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564120370 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8529 SOUTHPARK CIR STE 270 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328199017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073517080 | ||||||||
| FaxNumber: | 4073516930 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2014 | ||||||||
| LastUpdateDate: | 08/14/2019 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | RODNEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4073517080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2800X | 1000048 | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic |
No ID Information.