Provider Demographics
NPI:1336450808
Name:CRESCENT MEDICAL SERVICE PC
Entity Type:Organization
Organization Name:CRESCENT MEDICAL SERVICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVANG
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:306-983-6746
Mailing Address - Street 1:2101 CEDAR SPRINGS RD STE 1050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2165
Mailing Address - Country:US
Mailing Address - Phone:630-800-2741
Mailing Address - Fax:866-223-3460
Practice Address - Street 1:2101 CEDAR SPRINGS RD STE 1050
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-2165
Practice Address - Country:US
Practice Address - Phone:630-800-2741
Practice Address - Fax:866-223-3460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121863207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty