Healthcare Provider Details

I. General information

NPI: 1578883187
Provider Name (Legal Business Name): FETAL CARE CONSULTANTS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 FOREST LN STE 742
DALLAS TX
75230-2571
US

IV. Provider business mailing address

P.O. BOX 192647
DALLAS TX
75219-4129
US

V. Phone/Fax

Practice location:
  • Phone: 972-566-5600
  • Fax: 972-566-5680
Mailing address:
  • Phone: 214-824-9600
  • Fax: 214-824-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH MAGEE
Title or Position: OFFICE MANAGER
Credential:
Phone: 214-824-9600