Healthcare Provider Details

I. General information

NPI: 1063004703
Provider Name (Legal Business Name): WEST COKE COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2021
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 PARKS VILLAGE DR
ODESSA TX
79765-8987
US

IV. Provider business mailing address

111 PARKS VILLAGE DR
ODESSA TX
79765-8987
US

V. Phone/Fax

Practice location:
  • Phone: 432-563-5707
  • Fax:
Mailing address:
  • Phone: 432-563-5707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: WESLEY HOUSTON MCGUIRE
Title or Position: DISTRICT ADMINISTRATOR
Credential:
Phone: 325-453-2511