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NPI Code Detail

MEDICARE: NORTH TEXAS FERTILITY, LLC

MEDICARE: NORTH TEXAS FERTILITY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
145D1104505OTHERTXCLIA

General Provider Information

NPI Number : 1801106661
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH TEXAS FERTILITY, LLC
Provider Business Mailing Address
First Line : 950 SCOTLAND DR
Second Line :
City : DESOTO
State : TX
Zip : 75115-2057
Country : US
Telephone Number : 972-572-1226
Fax Number : 972-499-2469
Provider Business Practice Location Address
First Line : 950 SCOTLAND DR
Second Line :
City : DESOTO
State : TX
Zip : 75115-2057
Country : US
Telephone Number : 972-572-1226
Fax Number : 972-499-2469
Authorized Official
Title or Position : PRESIDENT
Name : DR. SUNDAY S CRIDER-PIRKLE
Credential : PH.D.
Telephone Number : 972-572-1226
Provider Enumeration Date : 10/14/2010
Last Update Date : 10/14/2010

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Directions to “NORTH TEXAS FERTILITY, LLC ” Practice Location

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