Individual
CHARLES CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
206 W WINDCREST ST, FREDERICKSBURG, TX 78624-4408
(830) 997-0252
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
224627
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202433007
UNICARE
TX
Enumeration date
07/29/2005
Last updated
04/29/2008
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