Provider Demographics
NPI:1932854809
Name:SAN ANTONIO FERTILITY SURGERY CENTER LLC
Entity Type:Organization
Organization Name:SAN ANTONIO FERTILITY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-370-3800
Mailing Address - Street 1:6500 N MOPAC EXPY BLDG I
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3282
Mailing Address - Country:US
Mailing Address - Phone:512-451-0149
Mailing Address - Fax:
Practice Address - Street 1:18707 HARDY OAK BLVD STE 505
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4891
Practice Address - Country:US
Practice Address - Phone:210-370-3800
Practice Address - Fax:210-370-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX804204308OtherOFFICE SECRETARY OF STATE