Organization Active NPI

Crescent Clinic PLLC

  • Primary Care Clinic/Center
  • Katy, TX
National Provider Identifier
1649825365
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CRESCENT CLINIC PLLC
Practice address
23211 Red River Dr
Katy, TX 77494-2031
Phone
(832) 437-2427
Fax
(281) 396-4798
NPI assigned
Aug 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Authorized official

Name
Dr. Shazia Farooq Sheikh, MDNPI 1033270806
Title
President
Phone
(281) 606-9547

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

23211 Red River Dr
Katy, TX 77494-2031

Mailing address

23211 Red River Dr
Katy, TX 77494-2031
Phone (832) 437-2427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191023002342 TX Part B Supplier - Clinic/Group Practice 0446582415 Receives reassigned benefits from 1 practitioner
Practice locations: Katy, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2176372Crescent Clinic PLLC23211 Red River Drive, Katy, TX 77494Certificate of waiverDec 11, 2027

National Provider Directory

National Provider Directory

Locations

23211 Red River Dr
Katy, TX 77494
Phone (281) 599-0300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1649825365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23211 RED RIVER DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942031",
            "telephone_number": "832-437-2427",
            "fax_number": "281-396-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23211 RED RIVER DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942031",
            "telephone_number": "832-437-2427",
            "fax_number": "281-396-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-08",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "SHEIKH",
        "authorized_official_first_name": "SHAZIA",
        "authorized_official_middle_name": "FAROOQ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-606-9547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.