Provider Demographics
NPI:1518921394
Name:TEXOMA MEDICAL SERVICES INC
Entity type:Organization
Organization Name:TEXOMA MEDICAL SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DAILY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-328-5208
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:111 S. BROADWAY
Mailing Address - City:TALOGA
Mailing Address - State:OK
Mailing Address - Zip Code:73667-0236
Mailing Address - Country:US
Mailing Address - Phone:580-328-5208
Mailing Address - Fax:580-328-5211
Practice Address - Street 1:116 NE 6TH ST
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942-4304
Practice Address - Country:US
Practice Address - Phone:580-338-6585
Practice Address - Fax:580-338-6545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100846370KMedicaid
=========005OtherBLUE CROSS BLUE SHIELD
OK100846370KMedicaid
OK1518921394Medicare NSC