Provider Demographics
NPI:1962778852
Name:AUSTIN CENTER FOR CLINICAL RESEARCH
Entity type:Organization
Organization Name:AUSTIN CENTER FOR CLINICAL RESEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FAHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-371-7702
Mailing Address - Street 1:4201 MARATHON BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3409
Mailing Address - Country:US
Mailing Address - Phone:832-475-7495
Mailing Address - Fax:512-371-7759
Practice Address - Street 1:4201 MARATHON BLVD STE 202
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3409
Practice Address - Country:US
Practice Address - Phone:512-371-7702
Practice Address - Fax:512-371-7750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH17951744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty