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General NPI Number Information
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NPI Number | 1942550801
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Entity Type | Organization
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Legal Business Name | CRESCENT DURABLE MEDICAL, LLC
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | 4085 OHIO DR SUITE 500
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City | FRISCO
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State | TX
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Zip | 75035-6244
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Country | US
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Telephone | 214-375-0101
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Fax | 214-375-0099
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Provider Business Mailing Address
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Address Line | 4085 OHIO DR SUITE 500
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City | FRISCO
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State | TX
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Zip | 75035-6244
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Country | US
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Telephone | 214-375-0101
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Fax | 214-375-0099
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Authorized Official
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Title or Position | OWNER
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Name | DR. KHALID MAHMOOD
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Credential | M.D.
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Telephone | 214-375-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1000832
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License Number State | TX
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