Provider Demographics
NPI:1093563546
Name:CRESCENT INFUSION HEALTH CLINIC PLLC
Entity type:Organization
Organization Name:CRESCENT INFUSION HEALTH CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAUD
Authorized Official - Middle Name:IQBAL
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-248-7407
Mailing Address - Street 1:1111 N LEE AVE # 249
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2600
Mailing Address - Country:US
Mailing Address - Phone:405-594-5848
Mailing Address - Fax:405-594-5847
Practice Address - Street 1:1111 N LEE AVE STE 249
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2600
Practice Address - Country:US
Practice Address - Phone:855-541-2862
Practice Address - Fax:405-716-4808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty