CCRM DALLAS FORT WORTH – NPI #1437636636
Clinic/Center

CCRM DALLAS FORT WORTH is an AHC clinic located in FRISCO, TX. NPPES has assigned the NPI number 1437636636 to CCRM DALLAS FORT WORTH on July 20, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CCRM DALLAS FORT WORTH” is a dba name, the actual legal business name for this organization is CCRM DFW, LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 8 years ago on Jul 25, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CCRM DALLAS FORT WORTH below.

NPI Profile for
CCRM DFW, LLC

NPI Number
1437636636
Enumeration Date

(about 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CCRM DFW, LLC
Doing Business As (dba): CCRM DALLAS FORT WORTH
Primary location
8380 WARREN PKWY STE 201
FRISCO, TX 75034
Phone: (972) 377-2625 Fax:
Mailing address
9380 STATION ST STE 425
LONE TREE, CO 80124-6832
Phone: (303) 968-1950 Fax:
Organization Subpart
No
Authorized Official
JON PARDEW
CEO
Phone: (303) 968-1950
Updated
Identifiers

Identifiers for CCRM DALLAS FORT WORTH

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERASC LICENSE130394
OTHERCLIA45D1095599
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)
291U00000X
- Clinical Medical Laboratory

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.