Provider Demographics
NPI:1801106661
Name:NORTH TEXAS FERTILITY, LLC
Entity type:Organization
Organization Name:NORTH TEXAS FERTILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position: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
Authorized Official - Phone:972-572-1226
Mailing Address - Street 1:950 SCOTLAND DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2057
Mailing Address - Country:US
Mailing Address - Phone:972-572-1226
Mailing Address - Fax:972-499-2469
Practice Address - Street 1:950 SCOTLAND DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2057
Practice Address - Country:US
Practice Address - Phone:972-572-1226
Practice Address - Fax:972-499-2469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D1104505OtherCLIA