Provider Demographics
NPI:1831409598
Name:CROSS ROADS WOMENS HEALTH P.A.
Entity type:Organization
Organization Name:CROSS ROADS WOMENS HEALTH P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-365-3030
Mailing Address - Street 1:3201 US HIGHWAY 380
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CROSSROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2464
Mailing Address - Country:US
Mailing Address - Phone:940-365-3030
Mailing Address - Fax:
Practice Address - Street 1:3201 US HIGHWAY 380
Practice Address - Street 2:SUITE 201
Practice Address - City:CROSSROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-2464
Practice Address - Country:US
Practice Address - Phone:940-365-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2590207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I66295Medicare UPIN