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General NPI Number Information
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NPI Number | 1144650375
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Entity Type | Organization
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Legal Business Name | COMPLETE FERTILITY CARE, PLLC
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Dates
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Enumeration Date | 11/25/2013
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4370 MEDICAL ARTS DR SUITE # 315
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1712
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Country | US
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Telephone | 214-223-1921
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Fax |
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Provider Business Mailing Address
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Address Line | 4370 MEDICAL ARTS DR SUITE # 315
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1712
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Country | US
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Telephone | 214-223-1921
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BARRY R. JACOBS
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Credential | M.D.
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Telephone | 214-223-1921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | D7099
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License Number State | TX
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