Provider Demographics
NPI:1689727752
Name:IVFMD, PA
Entity Type:Organization
Organization Name:IVFMD, PA
Other - Org Name:ADVANCED REPRODUCTIVE CARE CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SY
Authorized Official - Middle Name:Q
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-506-9986
Mailing Address - Street 1:7501 LAS COLINAS BLVD
Mailing Address - Street 2:200A
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-7518
Mailing Address - Country:US
Mailing Address - Phone:972-506-9986
Mailing Address - Fax:972-506-0044
Practice Address - Street 1:7501 LAS COLINAS BLVD
Practice Address - Street 2:200A
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-7518
Practice Address - Country:US
Practice Address - Phone:972-506-9986
Practice Address - Fax:972-506-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6372207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty