Basic Information
| Provider Information | |||||||||
| NPI: | 1497192660 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CROSSROADS HOSPITALIST ASSOCIATES, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 WATERMARK | ||||||||
| Address2: | |||||||||
| City: | VICTORIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779041168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3616523665 | ||||||||
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| Practice Location | |||||||||
| Address1: | 506 E SAN ANTONIO ST | ||||||||
| Address2: | |||||||||
| City: | VICTORIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779016060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3615757441 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2013 | ||||||||
| LastUpdateDate: | 08/07/2013 | ||||||||
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| AuthorizedOfficialLastName: | RAMOS | ||||||||
| AuthorizedOfficialFirstName: | ENGILBERTO | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3616523665 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.