=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972491470
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DCS MEDICAL PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2025
-----------------------------------------------------
Last Update Date | 06/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 921 E HWY 199
-----------------------------------------------------
City | SPRINGTOWN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76082
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-445-1210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 14950
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73113-0950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-445-1210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | STEVEN HULL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 405-445-1210
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------