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General NPI Number Information
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NPI Number | 1871309617
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Entity Type | Organization
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Legal Business Name | CRESCENT OASIS MEDICAL PLLC
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 01/18/2026
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Provider Practice Location Address
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Address Line | 1735 KELLER SPRINGS RD STE 101
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City | CARROLLTON
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State | TX
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Zip | 75006-2999
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Country | US
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Telephone | 972-704-1554
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Fax |
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Provider Business Mailing Address
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Address Line | 17727 ADDISON RD APT 124
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City | DALLAS
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State | TX
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Zip | 75287-0101
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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 | CHIEF EXECUTIVE OFFICER
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Name | DR. HAIDER BURNEY
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Credential | MD
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Telephone | 301-275-5552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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