Ccrm Dfw, LLC
Clinic/Center, Ambulatory Surgical in Frisco, TX. Organization (NPI-2).
NPI number1437636636
StatusActive
Last updated in NPPESJul 10, 2026
Details
- NPI
- 1437636636
- Entity type
- Organization (NPI-2)
- Legal business name
- Ccrm Dfw, LLC
- Organization subpart
- No
- Enumeration date
- Jul 20, 2018
- Certification date
- Jul 10, 2026
- Last updated
- Jul 10, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA1903X | Clinic/Center, Ambulatory Surgical | – | – | Yes |
| 291U00000X | Clinical Medical Laboratory | – | – |
Other names
- Ccrm Dallas Fort Worth (Doing Business As)
Practice location
8380 Warren Pkwy Ste 201Frisco, TX 75034
Phone 972-377-2625
Mailing address
8380 Warren Pkwy Ste 201Frisco, TX 75034-4199
Authorized official
Matt Tyson
Director, Managed Care Contracting
6154776677
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