Provider Demographics
NPI:1568084002
Name:CROSSROADS PHARMA LLC
Entity Type:Organization
Organization Name:CROSSROADS PHARMA LLC
Other - Org Name:CROSSROADS RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-815-0724
Mailing Address - Street 1:1919 WIRT RD STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-2405
Mailing Address - Country:US
Mailing Address - Phone:713-640-5236
Mailing Address - Fax:281-791-0376
Practice Address - Street 1:1919 WIRT RD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-2405
Practice Address - Country:US
Practice Address - Phone:713-640-5236
Practice Address - Fax:281-791-0376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy