Organization
CRENSHAW OCCUPATIONAL PRACTICE, PLLC
Active
Parent organization
PCP ASSOCIATES OF PASADENA PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PCP ASSOCIATES OF PASADENA PA
Authorized official
DR. DEEPAK PATTANAIK MD (MEDICAL DIRECTOR)
(281) 487-0807
Entity
Organization
Contact information
Practice address
5030 CRENSHAW RD STE 124, PASADENA, TX 77505-3141
(281) 487-0807
(281) 487-0806
Mailing address
5030 CRENSHAW RD STE 124, PASADENA, TX 77505-3141
(281) 487-0807
(281) 487-0806
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043003501
—
TX
05
—
114731602
—
TX
05
—
181889001
—
TX
Enumeration date
06/13/2019
Last updated
06/13/2019
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