Organization Active NPI

Fertility Center of Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
National Provider Identifier
1255641213
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
FERTILITY CENTER OF DALLAS
Practice address
3900 Junius St
Suite 610
Dallas, TX 75246-1615
Phone
(214) 823-2692
Fax
(214) 887-2844
NPI assigned
Oct 8, 2010
Last updated
Oct 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Michael Putman, MD
Title
Gerneral Partner / Medical Director
Phone
(214) 823-2692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

3900 Junius St
Suite 610
Dallas, TX 75246-1615

Mailing address

3900 Junius St
Suite 610
Dallas, TX 75246-1615
Phone (214) 823-2692

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2269838Texas Dermatology Research Center, LLC3900 Junius Street Suite 420, Dallas, TX 75246Certificate of waiverOct 3, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1255641213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST",
            "address_2": "SUITE 610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461615",
            "telephone_number": "214-823-2692",
            "fax_number": "214-887-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST",
            "address_2": "SUITE 610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461615",
            "telephone_number": "214-823-2692",
            "fax_number": "214-887-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERTILITY CENTER OF DALLAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "PUTMAN",
        "authorized_official_first_name": "JOHN MICHAEL",
        "authorized_official_title_or_position": "GERNERAL PARTNER / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "214-823-2692",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.