Basic Information
| Provider Information | |||||||||
| NPI: | 1114143252 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MEMORIAL HOSPITAL OF TEXAS COUNTY | ||||||||
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| Mailing Information | |||||||||
| Address1: | HCR #4 BOX 80 | ||||||||
| Address2: | |||||||||
| City: | GUYMON | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5803388136 | ||||||||
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| Practice Location | |||||||||
| Address1: | 520 MEDICAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | GUYMON | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5803386515 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HELM | ||||||||
| AuthorizedOfficialFirstName: | LYNETTE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST ASSIST. | ||||||||
| AuthorizedOfficialTelephone: | 5803386515 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | RPTA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283X00000X | TA516 | OK | Y | Hospitals | Rehabilitation Hospital |
No ID Information.