Healthcare Provider Details

I. General information

NPI: 1730791500
Provider Name (Legal Business Name): HILLCREST DALLAS CLINICAL RESEARCH INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 HEATHERDALE DR
LITTLE ELM TX
75068-6825
US

IV. Provider business mailing address

2501 HEATHERDALE DR
LITTLE ELM TX
75068-6825
US

V. Phone/Fax

Practice location:
  • Phone: 214-329-6414
  • Fax:
Mailing address:
  • Phone: 214-329-6414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHUKWUDI (CHUCK) A IJIOMA
Title or Position: ADMINISTRATOR
Credential:
Phone: 214-329-6414