Provider Demographics
NPI:1568514180
Name:TEXOMA MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:TEXOMA MEDICAL SERVICES, INC.
Other - Org Name:WESTERN DRUG #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:580-256-5586
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:TALOGA
Mailing Address - State:OK
Mailing Address - Zip Code:73667-0236
Mailing Address - Country:US
Mailing Address - Phone:580-328-5208
Mailing Address - Fax:580-328-5211
Practice Address - Street 1:1021 OKLAHOMA AVE STE A
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-4661
Practice Address - Country:US
Practice Address - Phone:580-256-5586
Practice Address - Fax:580-256-7574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336L0003X, 3336M0002X
OK44-49573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0002XSuppliersPharmacyMail Order PharmacyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100846370DMedicaid
OK100846370GMedicaid
OK100846370DMedicaid
OK100846370DMedicaid