Provider Demographics
NPI:1467452094
Name:UHS OF TRC, INC
Entity Type:Organization
Organization Name:UHS OF TRC, INC
Other - Org Name:SKILLED NURSING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:W.
Authorized Official - Middle Name:MACKEY
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-416-1426
Mailing Address - Street 1:1000 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-2035
Mailing Address - Country:US
Mailing Address - Phone:903-416-4007
Mailing Address - Fax:
Practice Address - Street 1:1000 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-2035
Practice Address - Country:US
Practice Address - Phone:903-416-4007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UHS OF TRC, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-26
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH2985OtherBLUE CROSS PROVIDER #
TX000925701Medicaid
TX000925701Medicaid