Provider Demographics
NPI:1649789819
Name:TEXOMA ER LLC
Entity type:Organization
Organization Name:TEXOMA ER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:JANCIE
Authorized Official - Middle Name:KRISTEN
Authorized Official - Last Name:SHELBURNE
Authorized Official - Suffix:
Authorized Official - Credentials:DON
Authorized Official - Phone:903-357-5003
Mailing Address - Street 1:2022 N US HIGHWAY 75
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2802
Mailing Address - Country:US
Mailing Address - Phone:903-357-5003
Mailing Address - Fax:903-357-5077
Practice Address - Street 1:2022 N HWY 75
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090
Practice Address - Country:US
Practice Address - Phone:903-357-5003
Practice Address - Fax:903-357-5077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care