Provider Demographics
NPI:1326483173
Name:CENTER FOR ASSISTED REPRODUCTION, PA
Entity Type:Organization
Organization Name:CENTER FOR ASSISTED REPRODUCTION, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-540-1157
Mailing Address - Street 1:1701 PARK PLACE AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6033
Mailing Address - Country:US
Mailing Address - Phone:817-540-1157
Mailing Address - Fax:817-545-2164
Practice Address - Street 1:10840 TEXAS HEALTH TRL
Practice Address - Street 2:SUITE 210
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6846
Practice Address - Country:US
Practice Address - Phone:817-540-1157
Practice Address - Fax:817-545-2164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty