Healthcare Provider Details

I. General information

NPI: 1952368243
Provider Name (Legal Business Name): TEXOMA MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 01/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 HAYES AVENUE
CLINTON OK
73601
US

IV. Provider business mailing address

PO BOX 236 111 S. BROADWAY
TALOGA OK
73667-0236
US

V. Phone/Fax

Practice location:
  • Phone: 580-323-4625
  • Fax: 580-323-4731
Mailing address:
  • Phone: 580-328-5208
  • Fax: 580-328-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN MARIE DAILY
Title or Position: VICE PRESIDENT OWNER
Credential:
Phone: 580-328-5208