Healthcare Provider Details

I. General information

NPI: 1255627121
Provider Name (Legal Business Name): CRESCENT VIEW MEDICAL CLINICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N NAVARRO ST
VICTORIA TX
77901-3912
US

IV. Provider business mailing address

2501 N NAVARRO ST
VICTORIA TX
77901-3912
US

V. Phone/Fax

Practice location:
  • Phone: 361-894-8745
  • Fax: 361-894-8748
Mailing address:
  • Phone: 361-894-8745
  • Fax: 361-894-8748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD H LEGGETT
Title or Position: OWNER/DIRECTOR
Credential: DO
Phone: 361-579-1371