Provider Demographics
NPI:1871736223
Name:NORTH TEXAS FERTILITY, LLC
Entity type:Organization
Organization Name:NORTH TEXAS FERTILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNDAY
Authorized Official - Middle Name:S
Authorized Official - Last Name:CRIDER-PIRKLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, HCLD/ELD (ABB)
Authorized Official - Phone:214-947-0278
Mailing Address - Street 1:3500 W WHEATLAND RD
Mailing Address - Street 2:2ND FLOOR, OUTPATIENT BLDG
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3460
Mailing Address - Country:US
Mailing Address - Phone:214-947-0278
Mailing Address - Fax:214-947-0279
Practice Address - Street 1:3500 W WHEATLAND RD
Practice Address - Street 2:2ND FLOOR, OUTPATIENT BLDG
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3460
Practice Address - Country:US
Practice Address - Phone:214-947-0278
Practice Address - Fax:214-947-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D1045407291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory