CRESCENT NEUROLOGY P.A. , NPI 1992795751 — HOUSTON (TX)

NPI 1992795751

14+ Years Experience Organization

CRESCENT NEUROLOGY P.A.

10/24/2005
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1992795751
NPI NUMBER

About CRESCENT NEUROLOGY P.A.

CRESCENT NEUROLOGY P.A. is a provider established in HOUSTON, TX. The NPI number of CRESCENT NEUROLOGY P.A. is 1992795751 and was assigned on 10/24/2005. The practitioners primary taxonomy code is: 261QM2500X with license number: M1780 TX .

Mailing address

  • City: HOUSTON
  • State: TX
  • Postal code: 772733829
  • Phone: 2815868800
  • Fax: 2815868822
  • Address: PO BOX 73829

Primary Practice Address

  • Region : HOUSTON, TX
  • NPI : 1992795751
  • Phone : 2815868800
  • Fax : 2815868822
  • Postalcode : 770902900
  • Address : 800 PEAKWOOD DR SUITE 6-D

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QM2500X
  • License number: M1780
  • License state: TX

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children"s Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Contacts:

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  • CRESCENT NEUROLOGY P.A.
  • Address : 800 PEAKWOOD DR SUITE 6-D
  • Region : HOUSTON, TX
  • NPI : 1992795751
  • Phone : 2815868800
  • Fax : 2815868822
  • Postalcode : 770902900

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 2815868800
  • Title or position : PRESIDENT
  • Credentials : M.D.

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address800 PEAKWOOD DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 6-D
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameHOUSTON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code770902900
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2815868800
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2815868822
The fax number associated with the location address of the provider being identified.
NPI1992795751
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QM2500X
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children"s Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Provider Enumeration Date10/24/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)CRESCENT NEUROLOGY P.A.
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 73829
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameHOUSTON
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTX
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code772733829
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2815868800
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number2815868822
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameIBRAHIM
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameFATIMA
The first name of the authorized official
Authorized Official Title or PositionPRESIDENT
The title or position of the authorized official
Authorized Official Name Prefix TextDR.
Authorized Official Name Prefix Text
Authorized Official Credential TextM.D.
Authorized Official Credential Text
Authorized Official Telephone Number2815868800
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QM2500X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children"s Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Provider License Number 1M1780
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1TX
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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