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General NPI Number Information
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NPI Number | 1578972352
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Entity Type | Organization
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Legal Business Name | ADVANCED FERTILITY CENTERS,LLC
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 605 E 4TH ST
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City | ODESSA
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State | TX
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Zip | 79761-5100
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Country | US
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Telephone | 812-201-6368
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Fax |
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Provider Business Mailing Address
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Address Line | 605 E 4TH ST
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City | ODESSA
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State | TX
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Zip | 79761-5100
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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 | MEMBER
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Name | DR. RIZWAN MALIK
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Credential |
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Telephone | 812-201-6368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | Q0311
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License Number State | TX
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