Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Northlake Obstetrics & Gynecology, P.A. before sending sensitive documents. FaxFlow is not affiliated with this organization.

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Northlake Obstetrics & Gynecology, P.A. fax number

(972) 981-7712

Obstetrics & Gynecology

Used for: Medical records requests and other medical communications (e.g., test results, appointment notes) via fax

Fax destination details

Department
Obstetrics & Gynecology
Purpose
Medical records requests and other medical communications (e.g., test results, appointment notes) via fax
Form
Authorization to Release Medical Records — Authorization to Release Medical Records
Address
6124 W Parker Rd, Plano, TX 75093
Voice phone
972-981-7711

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Complete, sign, and return this form to Northlake Obstetrics & Gynecology; indicate which records to release; records may incur a fee; authorization is valid for 30 days from the signature.

Official form instructions are published as a downloadable file on the organization's website.

Sources and verification

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