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General NPI Number Information
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NPI Number | 1871736223
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Entity Type | Organization
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Legal Business Name | NORTH TEXAS FERTILITY, LLC
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 3500 W WHEATLAND RD 2ND FLOOR, OUTPATIENT BLDG
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City | DALLAS
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State | TX
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Zip | 75237-3460
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Country | US
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Telephone | 214-947-0278
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Fax | 214-947-0279
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Provider Business Mailing Address
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Address Line | 3500 W WHEATLAND RD 2ND FLOOR, OUTPATIENT BLDG
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City | DALLAS
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State | TX
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Zip | 75237-3460
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Country | US
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Telephone | 214-947-0278
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Fax | 214-947-0279
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Authorized Official
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Title or Position | DIRECTOR/PRESIDENT
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Name | DR. SUNDAY S CRIDER-PIRKLE
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Credential | PHD, HCLD/ELD (ABB)
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Telephone | 214-947-0278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 45D1045407
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License Number State | TX
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