Provider Demographics
NPI:1740790757
Name:CROSSROADS WALK-IN AND URGENT CARE CENTER, PLLC
Entity Type:Organization
Organization Name:CROSSROADS WALK-IN AND URGENT CARE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-573-9999
Mailing Address - Street 1:4504 N LAURENT ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-2743
Mailing Address - Country:US
Mailing Address - Phone:361-573-9999
Mailing Address - Fax:361-573-9973
Practice Address - Street 1:4504 N LAURENT ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-2743
Practice Address - Country:US
Practice Address - Phone:361-573-9999
Practice Address - Fax:361-573-9973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty