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General NPI Number Information
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NPI Number | 1891177804
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Entity Type | Organization
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Legal Business Name | FERTILITY INSTITUTE OF TEXAS, PLLC
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 540 OAK CENTRE DR STE 260
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4767
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Country | US
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Telephone | 210-277-8111
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Fax | 830-620-9077
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Provider Business Mailing Address
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Address Line | 540 OAK CENTRE DR STE 260
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4767
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Country | US
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Telephone | 210-277-8111
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Fax | 830-620-9077
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. SUSAN B. HUDSON
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Credential | M.D.
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Telephone | 830-660-8442
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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 | L9256
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License Number State | TX
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