Provider Demographics
NPI:1710349352
Name:MEMORIAL HOSPITAL OF TEXAS COUNTY
Entity Type:Organization
Organization Name:MEMORIAL HOSPITAL OF TEXAS COUNTY
Other - Org Name:KEYES WOMEN'S CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-338-3113
Mailing Address - Street 1:520 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-4438
Mailing Address - Country:US
Mailing Address - Phone:580-338-6515
Mailing Address - Fax:580-338-5722
Practice Address - Street 1:401 N POLK AVE
Practice Address - Street 2:
Practice Address - City:KEYES
Practice Address - State:OK
Practice Address - Zip Code:73947
Practice Address - Country:US
Practice Address - Phone:580-546-7116
Practice Address - Fax:580-546-7226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty