Provider Demographics
NPI:1730791500
Name:HILLCREST DALLAS CLINICAL RESEARCH INCORPORATED
Entity type:Organization
Organization Name:HILLCREST DALLAS CLINICAL RESEARCH INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUKWUDI (CHUCK)
Authorized Official - Middle Name:A
Authorized Official - Last Name:IJIOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-329-6414
Mailing Address - Street 1:2501 HEATHERDALE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6825
Mailing Address - Country:US
Mailing Address - Phone:214-329-6414
Mailing Address - Fax:
Practice Address - Street 1:2501 HEATHERDALE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-6825
Practice Address - Country:US
Practice Address - Phone:214-329-6414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty