Provider Demographics
NPI:1942260971
Name:TPG HOSPITAL LLC
Entity Type:Organization
Organization Name:TPG HOSPITAL LLC
Other - Org Name:NORTHWEST SURGICAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-763-3890
Mailing Address - Street 1:9204 N MAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-4419
Mailing Address - Country:US
Mailing Address - Phone:405-848-1918
Mailing Address - Fax:405-848-7537
Practice Address - Street 1:9204 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-4419
Practice Address - Country:US
Practice Address - Phone:405-848-1918
Practice Address - Fax:405-848-7537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2329282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK20035670CMedicaid
OK370192Medicare Oscar/Certification