Organization
DALLAS FORT WORTH IVF LLC
Active
Other names
Dallas Fertility Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL J CHANTILIS M.D. (PRESIDENT)
(214) 363-5965
Entity
Organization
Contact information
Practice address
5477 GLEN LAKES DR, SUITE 201, DALLAS, TX 75231-0946
(214) 363-5965
(214) 363-0639
Mailing address
5477 GLEN LAKES DR, SUITE 201, DALLAS, TX 75231-0946
(214) 363-5965
(214) 363-0639
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D1095599
TX
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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