Provider Demographics
NPI:1114236304
Name:GRAYSON COUNTY PHYSICIAN'S PROPERTY, LLC
Entity Type:Organization
Organization Name:GRAYSON COUNTY PHYSICIAN'S PROPERTY, LLC
Other - Org Name:HERITAGE PARK SURGICAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LEGAL ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-608-1766
Mailing Address - Street 1:14000 N. PORTLAND AVEUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-4004
Mailing Address - Country:US
Mailing Address - Phone:405-608-1766
Mailing Address - Fax:405-608-1866
Practice Address - Street 1:3601 CALAIS STREET
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090
Practice Address - Country:US
Practice Address - Phone:903-813-3700
Practice Address - Fax:903-813-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital