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General NPI Number Information
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NPI Number | 1053690735
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Entity Type | Organization
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Legal Business Name | CRESCENT CARDIOLOGY ASSOCIATES
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 8401 MEMORIAL LN #7445
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City | PLANO
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State | TX
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Zip | 75024-2285
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Country | US
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Telephone | 214-794-3511
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Fax | 214-291-5829
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Provider Business Mailing Address
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Address Line | 8401 MEMORIAL LN #7445
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City | PLANO
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State | TX
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Zip | 75024-2285
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Country | US
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Telephone | 214-794-3511
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Fax | 214-291-5829
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. FAYAK SHAMEEM KAMILI
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Credential | M.D.
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Telephone | 214-794-3511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | N4507
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License Number State | TX
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