Provider Demographics
NPI:1730410861
Name:CENTER FOR ASSISTED REPRODUCTION LABORATORY AND SURGERY CENTER INC
Entity type:Organization
Organization Name:CENTER FOR ASSISTED REPRODUCTION LABORATORY AND SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:DUSTEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
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 1:4461 COIT RD
Practice Address - Street 2:STE 307
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0521
Practice Address - Country:US
Practice Address - Phone:972-661-9544
Practice Address - Fax:469-633-7224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory