Provider Demographics
NPI:1043454531
Name:NORTH TEXAS ENT BRENT METTS MD PA
Entity type:Organization
Organization Name:NORTH TEXAS ENT BRENT METTS MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:A
Authorized Official - Last Name:METTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-475-9151
Mailing Address - Street 1:7801 LAKEVIEW PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4247
Mailing Address - Country:US
Mailing Address - Phone:972-475-9151
Mailing Address - Fax:972-475-1757
Practice Address - Street 1:7801 LAKEVIEW PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4247
Practice Address - Country:US
Practice Address - Phone:972-475-9151
Practice Address - Fax:972-475-1757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0032765201Medicaid
TX0032765201Medicaid