CCST ASSOCIATES PLLC NPI 1023117157

NPI Information

  • NPI: 1023117157
  • Provider Name: CCST ASSOCIATES PLLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 221 W COLORADO BLVD
    SUITE 100
    DALLAS, TX
    ZIP 75208
  • Phone: (214) 943-8605

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NPI Details

CCST ASSOCIATES PLLC is a specialist in Dallas, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. CCST ASSOCIATES PLLC NPI is 1023117157. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

221 W COLORADO BLVD
SUITE 100
DALLAS, TX
ZIP 75208
Phone: (214) 943-8605
Fax: (214) 941-3076

The provider's authorized official is Alicia J Mangram .
The authorized official title is Trauma Surgeon and has the following contact phone number (214) 943-8605.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 10/17/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistJ8654TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H42389MEDICARE UPIN
2144729404MEDICAIDTEXAS
38A6735MEDICARE ID-TYPE UNSPECIFIEDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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