Provider Demographics
NPI:1548547821
Name:REPROMED FERTILITY CENTER PLLC
Entity type:Organization
Organization Name:REPROMED FERTILITY CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PINTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-827-8777
Mailing Address - Street 1:6411 ORCHID LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-4120
Mailing Address - Country:US
Mailing Address - Phone:214-827-8777
Mailing Address - Fax:214-827-8622
Practice Address - Street 1:3800 SAN JACINTO ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-5225
Practice Address - Country:US
Practice Address - Phone:214-827-8777
Practice Address - Fax:214-827-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5095207VG0400X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty