Provider Demographics
NPI:1225216930
Name:DOCTORS MEDICAL CENTER CLINIC
Entity Type:Organization
Organization Name:DOCTORS MEDICAL CENTER CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RHC OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:LUCKIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-879-4910
Mailing Address - Street 1:10201 HWY 16 NORTH
Mailing Address - Street 2:
Mailing Address - City:COMANCHE
Mailing Address - State:TX
Mailing Address - Zip Code:76442-0000
Mailing Address - Country:US
Mailing Address - Phone:254-879-4910
Mailing Address - Fax:254-879-4991
Practice Address - Street 1:10201 HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:TX
Practice Address - Zip Code:76442-4462
Practice Address - Country:US
Practice Address - Phone:254-879-4910
Practice Address - Fax:254-879-4991
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMANCHE COUNTY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty