Crenshaw Occupational Practice, PLLC

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

Legal business name

CRENSHAW OCCUPATIONAL PRACTICE, PLLC

Practice address

5030 Crenshaw Rd Ste 124
Pasadena, TX 77505-3141

Phone

(281) 487-0807

Fax

(281) 487-0806

NPI assigned

Jun 13, 2019

Last updated

Jun 13, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

PCP ASSOCIATES OF PASADENA PAAs reported in NPPES

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

Authorized official

Name

Dr. Deepak Pattanaik, MD

Title

Medical Director

Phone

(281) 487-0807

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Part of

PCP Associates of Pasad

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• PCP Associates of Pasadena PA

  • Family Medicine Physician
  • Pasadena, TX
  • NPI 1467673301
  NPPES parent name

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1932769825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CRENSHAW RD STE 124",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053141",
            "telephone_number": "281-487-0807",
            "fax_number": "281-487-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 CRENSHAW RD STE 124",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053141",
            "telephone_number": "281-487-0807",
            "fax_number": "281-487-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRENSHAW OCCUPATIONAL PRACTICE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PCP ASSOCIATES OF PASADENA PA",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "PATTANAIK",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "281-487-0807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114731602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043003501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181889001",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "50.208.82.113",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5030 Crenshaw Rd Ste 124",
            "city": "Pasadena",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775053141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Edward Anthony Cortez Sr., DDS
• Paul Bruce Covell, D.D.S.
• John Edward Covington, CRNA
• Melissa H Crain, RPH
• Crenshaw Ambulatory Surgical Center, LLC
• Natalie Cribley, L.M.T.
• Ivanna Carla Crippa
• Crosswires Electric (Cwe Provider Service)
• Jana Lynn Crouch
• Crown of the Valley Emergency Physicians PLLC

• Occupational Medicine Clinic/Center in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Occupational Medicine Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.