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General NPI Number Information
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NPI Number | 1356737423
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Entity Type | Organization
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Legal Business Name | CRESCENT CHIROPRACTIC & PAIN CENTER
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 2700 W PLEASANT RUN RD
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City | LANCASTER
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State | TX
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Zip | 75146-1079
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Country | US
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Telephone | 214-534-3826
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 MONTEREY DR
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City | FRISCO
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State | TX
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Zip | 75034-4084
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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 | DR. ASSIA MAHMOOD
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Credential | D.C.
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Telephone | 214-534-3826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12845
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License Number State | TX
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