Crescent Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M1677 Issued in TX

Legal business name

CRESCENT FAMILY MEDICINE

Practice address

820 S Alma Dr
Suite 130
Allen, TX 75013-3808

Phone

(972) 747-0777

Fax

(214) 383-4559

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Pedro V Marzocca

Title

Practice Administrator

Phone

(972) 747-0777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1699708990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S ALMA DR",
            "address_2": "SUITE 130",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133808",
            "telephone_number": "972-747-0777",
            "fax_number": "214-383-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S ALMA DR",
            "address_2": "SUITE 130",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133808",
            "telephone_number": "972-747-0777",
            "fax_number": "214-383-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "MARZOCCA",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "972-747-0777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M1677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5NP",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Allen, TX
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• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.