Organization
CROSS MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA RODRIGUEZ FULLER FNP (OWNER)
(806) 418-5880
Entity
Organization
Contact information
Practice address
1619 4TH AVE, CANYON, TX 79015-3824
(806) 418-5880
Mailing address
PO BOX 1614, CANYON, TX 79015-1614
(806) 557-4138
(806) 557-4165
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
694365
TX
Other
Enumeration date
10/06/2013
Last updated
10/14/2013
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