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General NPI Number Information
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NPI Number | 1548978638
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Entity Type | Organization
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Legal Business Name | E2P4 LABS, LLC
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Dates
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Enumeration Date | 11/08/2022
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 5288 TOWNE SQUARE DRIVE
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City | PLANO
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State | TX
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Zip | 75024
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Country | US
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Telephone | 469-443-4329
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Fax | 817-947-0008
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Provider Business Mailing Address
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Address Line | 1560 E SOUTHLAKE BLVD SUITE 100 UNIT #108A
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City | SOUTHLAKE
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State | TX
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Zip | 76092
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Country | US
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Telephone | 469-443-4329
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Fax | 817-947-0008
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BEVERLY REED
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Credential | MD
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Telephone | 979-571-2434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0006X
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Taxonomy Name | Ambulatory Fertility Facility
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License Number |
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License Number State |
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