Provider Demographics
NPI:1841698453
Name:ACUTE CARE SURGERY TEXOMA PLLC
Entity type:Organization
Organization Name:ACUTE CARE SURGERY TEXOMA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-781-2272
Mailing Address - Street 1:PO BOX 3386
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-0386
Mailing Address - Country:US
Mailing Address - Phone:940-781-2272
Mailing Address - Fax:940-687-7005
Practice Address - Street 1:1600 11TH ST
Practice Address - Street 2:TRAUMA SERVICES
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4300
Practice Address - Country:US
Practice Address - Phone:940-781-2272
Practice Address - Fax:940-761-1909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty