CCRM DFW LLC NPI 1437636636

NPI Information

NPI: 1437636636
Provider Name: CCRM DFW, LLC

Doing Business As: CCRM DALLAS FORT WORTH

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
8380 WARREN PKWY STE 201
FRISCO, TX
ZIP 75034
Phone: (972) 377-2625
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CCRM DFW, LLC is an ambulatory surgical clinic center in Frisco, TX. CCRM DFW, LLC NPI is 1437636636. The provider is registered as an organization entity type.
The provider Is Doing Business As Ccrm Dallas Fort Worth.

The provider's business location address is:

8380 WARREN PKWY STE 201
FRISCO, TX
ZIP 75034
Phone: (972) 377-2625

The provider's authorized official is Jon Pardew .
The authorized official title is Ceo and has the following contact phone number (303) 968-1950.

The enumeration date for this NPI number is 7/20/2018 and was last updated on 7/25/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	291U00000X	Clinical Medical Laboratory				No
2	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	45D1095599	OTHER		CLIA
2	130394	OTHER		ASC LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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