Healthcare Provider Details

I. General information

NPI: 1548407828
Provider Name (Legal Business Name): HOUSTON IVF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 01/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 GESSNER STE. 2300
HOUSTON TX
77024-2501
US

IV. Provider business mailing address

929 GESSNER STE. 2300
HOUSTON TX
77024-2501
US

V. Phone/Fax

Practice location:
  • Phone: 713-465-1211
  • Fax: 713-550-1475
Mailing address:
  • Phone: 713-465-1211
  • Fax: 713-550-1475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY HICKMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 713-465-1211