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General NPI Number Information
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NPI Number | 1982020681
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Entity Type | Organization
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Legal Business Name | COMMUNITY CLINICAL RESEARCH
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 8334 CROSS PARK DR
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City | AUSTIN
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State | TX
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Zip | 78754-5122
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Country | US
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Telephone | 512-323-2622
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Fax | 512-323-2625
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Provider Business Mailing Address
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Address Line | 8334 CROSS PARK DR
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City | AUSTIN
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State | TX
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Zip | 78754-5122
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Country | US
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Telephone | 512-323-2622
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Fax | 512-323-2625
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Authorized Official
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Title or Position | DIR,BUSINESS DEVELOPMENT
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Name | JANICE ROGGENKAMP
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Credential |
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Telephone | 713-665-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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