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General NPI Number Information
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NPI Number | 1245405273
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Entity Type | Organization
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Legal Business Name | MALE FERTILITY SPECIALISTS, P.A.
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 5616 WARREN PKWY SUITE 101
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City | FRISCO
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State | TX
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Zip | 75034-4166
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Country | US
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Telephone | 972-612-7131
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Fax |
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Provider Business Mailing Address
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Address Line | 5616 WARREN PKWY SUITE 101
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City | FRISCO
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State | TX
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Zip | 75034-4166
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. CLIFTON LEE
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Credential |
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Telephone | 972-612-7131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G9071
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License Number State | TX
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