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Organization
CRESTCARE FAMILY MEDICINE,PLLC
Active
Organization
CRESTCARE FAMILY MEDICINE,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAURANGI M ANKLESARIA MD (OWNER)
(918) 251-9698
Entity
Organization
Contact information
Practice address
817 S ELM PL STE 104, BROKEN ARROW, OK 74012-5369
(918) 251-9698
(405) 241-9022
Mailing address
817 S ELM PL STE 104, BROKEN ARROW, OK 74012-5369
(918) 251-9698
(405) 241-9022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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