Provider Demographics
NPI:1720178361
Name:HUNT COUNTY MEDICAL PROPERTIES
Entity Type:Organization
Organization Name:HUNT COUNTY MEDICAL PROPERTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCKENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:903-356-2144
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:QUINLAN
Mailing Address - State:TX
Mailing Address - Zip Code:75474-0008
Mailing Address - Country:US
Mailing Address - Phone:903-356-2144
Mailing Address - Fax:903-356-3025
Practice Address - Street 1:1607 EAST QUINLAN PARKWAY
Practice Address - Street 2:
Practice Address - City:QUINLAN
Practice Address - State:TX
Practice Address - Zip Code:75474-8632
Practice Address - Country:US
Practice Address - Phone:903-356-2144
Practice Address - Fax:903-356-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN084483901Medicaid
TX0097EBOtherBC/BS
TX123629105Medicaid
TX084483902Medicaid
TN084483901Medicaid