MEDICARE: ASPIRE FERTILITY INSTITUTE HOUSTON

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
1	207VE0102X	Reproductive Endocrinology Physician

General Provider Information

NPI Number	:	1922480482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRE FERTILITY INSTITUTE HOUSTON

Provider Business Mailing Address
First Line	:	4828 LOOP CENTRAL DRIVE
Second Line	:	STE 900
City	:	HOSUTON
State	:	TX
Zip	:	77081
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7515 MAIN ST
Second Line	:	STE 500
City	:	HOUSTON
State	:	TX
Zip	:	77030-4513
Country	:	US
Telephone Number	:	713-730-2229
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT, PAYOR RELATIONS
Name	:	MARIANNE DEBENEDICTIS
Credential	:
Telephone Number	:	713-254-3601

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	11/16/2022

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