Provider Demographics
NPI:1144650375
Name:COMPLETE FERTILITY CARE, PLLC
Entity type:Organization
Organization Name:COMPLETE FERTILITY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-223-1921
Mailing Address - Street 1:4370 MEDICAL ARTS DR
Mailing Address - Street 2:SUITE # 315
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1712
Mailing Address - Country:US
Mailing Address - Phone:214-223-1921
Mailing Address - Fax:
Practice Address - Street 1:4370 MEDICAL ARTS DR
Practice Address - Street 2:SUITE # 315
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1712
Practice Address - Country:US
Practice Address - Phone:214-223-1921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7099261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAJ6177720OtherDEA