Provider Demographics
NPI:1427366152
Name:DANIEL LENNARD CRESON PA
Entity Type:Organization
Organization Name:DANIEL LENNARD CRESON PA
Other - Org Name:DANIEL CRESON, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRESON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-387-6250
Mailing Address - Street 1:PO BOX 93042
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78709-3042
Mailing Address - Country:US
Mailing Address - Phone:940-387-6250
Mailing Address - Fax:940-387-6274
Practice Address - Street 1:914 N LOCUST ST.
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2954
Practice Address - Country:US
Practice Address - Phone:940-387-6250
Practice Address - Fax:940-387-6274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD05672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty