Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center | |
Ambulatory Fertility Facility |
261QA0006X |
| NPI Number | 1861257396 |
| LBN Legal business name | CCRM AUSTIN, LLC |
| Authorized official | DIANE RAVECH - (CHIEF MANAGED CARE OFFICER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/14/2024 |
| Last updated | 04/24/2025 - More than a year ago |
| Identifiers | n/a |
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CCRM AUSTIN, LLC
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