Provider Demographics
NPI:1578679536
Name:HOPKINS COUNTY PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:HOPKINS COUNTY PHYSICIAN SERVICES
Other - Org Name:MEMORIAL CLINIC RHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-438-3336
Mailing Address - Street 1:PO BOX 1367
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75483-1367
Mailing Address - Country:US
Mailing Address - Phone:903-885-3181
Mailing Address - Fax:903-885-1329
Practice Address - Street 1:105 MEDICAL PLAZA
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2136
Practice Address - Country:US
Practice Address - Phone:903-885-3181
Practice Address - Fax:903-885-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2012-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121476904Medicaid
TX121476904Medicaid