Organization
CCRM AUSTIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE JEAN RAVECH (CHIEF MANAGED CARE OFFICER)
(860) 305-6640
Entity
Organization
Contact information
Practice address
5301 SOUTHWEST PKWY STE 350, AUSTIN, TX 78735-8985
(727) 410-3707
Mailing address
9380 STATION ST STE 425, LONE TREE, CO 80124-6832
(303) 968-1950
Taxonomy
Speciality
Code
Description
License number
State
261QA0006X
Ambulatory Fertility Facility
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/14/2024
Last updated
04/24/2025
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