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General NPI Number Information
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NPI Number | 1225500556
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Entity Type | Organization
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Legal Business Name | CRIC ENTERPRISE LLC
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Dates
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Enumeration Date | 12/27/2018
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Last Update Date | 02/17/2019
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Provider Practice Location Address
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Address Line | 6040 BARRINGTON AVE
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City | BEAUMONT
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State | TX
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Zip | 77706-7379
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Country | US
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Telephone | 409-356-6892
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Fax | 409-356-6892
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Provider Business Mailing Address
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Address Line | 6040 BARRINGTON AVE
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City | BEAUMONT
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State | TX
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Zip | 77706-7379
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Country | US
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Telephone | 409-356-6892
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Fax | 409-356-6892
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Authorized Official
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Title or Position | PARTNER
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Name | ABSAR QURESHI
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Credential | MD
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Telephone | 409-356-6892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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