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General NPI Number Information
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NPI Number | 1043934698
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Entity Type | Organization
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Legal Business Name | CRESCENT PAIN & SPINE LLC
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 990 S SHERMAN ST
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City | RICHARDSON
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State | TX
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Zip | 75081-4845
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Country | US
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Telephone | 202-985-2191
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Fax |
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Provider Business Mailing Address
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Address Line | 403 MICHAEL DR
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City | MURPHY
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State | TX
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Zip | 75094-3761
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EDNAN SHEIKH
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Credential |
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Telephone | 202-985-2191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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