Provider Demographics
NPI:1609030105
Name:CRESCENT MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:CRESCENT MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-651-3656
Mailing Address - Street 1:7457 HARWIN DR
Mailing Address - Street 2:STE 105C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2018
Mailing Address - Country:US
Mailing Address - Phone:832-651-3656
Mailing Address - Fax:713-400-1385
Practice Address - Street 1:7457 HARWIN DR
Practice Address - Street 2:STE 105C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2018
Practice Address - Country:US
Practice Address - Phone:832-651-3656
Practice Address - Fax:713-400-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health