MEDICARE: CRESCENT CLINIC PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1649825365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT CLINIC PLLC

Provider Business Mailing Address
First Line	:	23211 RED RIVER DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-2031
Country	:	US
Telephone Number	:	832-437-2427
Fax Number	:	281-396-4798

Provider Business Practice Location Address
First Line	:	23211 RED RIVER DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-2031
Country	:	US
Telephone Number	:	832-437-2427
Fax Number	:	281-396-4798

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SHAZIA FAROOQ SHEIKH
Credential	:	MD
Telephone Number	:	281-606-9547

Provider Enumeration Date	:	08/08/2019
Last Update Date	:	06/11/2021

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Directions to “CRESCENT CLINIC PLLC ” Practice Location

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