Provider Demographics
NPI:1184279127
Name:CROSSROADS WOMEN'S HEALTH PLLC
Entity type:Organization
Organization Name:CROSSROADS WOMEN'S HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:MONIKA
Authorized Official - Last Name:ZANDOMENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-771-9910
Mailing Address - Street 1:PO BOX 25466
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1307 RIDGE RD STE 1106
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4301
Practice Address - Country:US
Practice Address - Phone:214-771-9910
Practice Address - Fax:214-771-9905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty