MEDICARE: CRESCENT DME SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	0039845	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	531546	OTHER	TX	BC/BS PROVIDER

General Provider Information

NPI Number	:	1831122829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT DME SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 182411
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76096-2411
Country	:	US
Telephone Number	:	817-801-1212
Fax Number	:	817-801-0005

Provider Business Practice Location Address
First Line	:	2238 MICHIGAN AVE
Second Line	:	G
City	:	ARLINGTON
State	:	TX
Zip	:	76013-5945
Country	:	US
Telephone Number	:	807-801-1212
Fax Number	:	817-801-0005

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MOHAMMED I SHAIKH
Credential	:
Telephone Number	:	817-801-1212

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/11/2010

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