Provider Demographics
NPI:1134525629
Name:TEXOMA QUICKCARE LLC
Entity type:Organization
Organization Name:TEXOMA QUICKCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:L
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-727-2149
Mailing Address - Street 1:4608 QUAIL RUN RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-8727
Mailing Address - Country:US
Mailing Address - Phone:615-727-2149
Mailing Address - Fax:
Practice Address - Street 1:4001 N US HIGHWAY 75
Practice Address - Street 2:SUITE 400
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2573
Practice Address - Country:US
Practice Address - Phone:615-727-2149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center