National Provider Identifier Database

CCRM DFW LLC
Ambulatory Surgical


Contact Information

CCRM DFW, LLC
8380 WARREN PKWY STE 201
FRISCO, TX75034
Phone: 972-377-2625
Fax:
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X
Clinical Medical Laboratory 291U00000X

* Indicates primary specialty

NPI Profile & details for CCRM DFW, LLC

NPI Number 1437636636
Legal business name
LBN
CCRM DFW, LLC
Authorized official JON PARDEW - (CEO)
Entity Organization
Organization subpart No
Enumeration date 07/20/2018
Last updated 07/25/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • Other: 130394 ASC LICENSE
  • Other: 45D1095599 CLIA

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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