Healthcare Provider Details
I. General information
NPI: 1518921394
Provider Name (Legal Business Name): TEXOMA MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2006
Last Update Date: 08/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
116 NE 6TH ST
GUYMON OK
73942-4304
US
IV. Provider business mailing address
PO BOX 236 111 S. BROADWAY
TALOGA OK
73667-0236
US
V. Phone/Fax
- Phone: 580-338-6585
- Fax: 580-338-6545
- Phone: 580-328-5208
- Fax: 580-328-5211
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen 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