Provider Demographics
NPI:1477553113
Name:UHS OF TRC, INC
Entity Type:Organization
Organization Name:UHS OF TRC, INC
Other - Org Name:TEXOMA MEDICAL CENTER RESTORATIVE CARE HOSPITAL
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?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000705282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH0901OtherBLUE CROSS PRIVIDER #
TXHH0901OtherBLUE CROSS PRIVIDER #