Crestline One Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CRESTLINE ONE SUPPLIES LLC

Practice address

21 Mockingbird LN
Dayton, TX 77535-9215

Phone

(832) 655-8383

NPI assigned

Sep 9, 2026

Last updated

Sep 9, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shaheena Khan

Title

Owner

Phone

(832) 655-8383

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1417867631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9659 N SAM HOUSTON PKWY E STE 150",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773961290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MOCKINGBIRD LN",
            "city": "DAYTON",
            "state": "TX",
            "postal_code": "775359215",
            "telephone_number": "832-655-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTLINE ONE SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-09",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHAHEENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-655-8383"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.