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Organization
INTEGRIS BASS BAPTIST HEALTH CENTER
Active
Organization
INTEGRIS BASS BAPTIST HEALTH CENTER
Active
Other names
INTEGRIS HEALTH MEDICAL GROUP WAYNOKA
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA WALLACE (ASSISTANT TREASURER)
(636) 359-4890
Entity
Organization
Contact information
Practice address
1084 NICKERSON ST, WAYNOKA, OK 73860-1245
(580) 824-2281
Mailing address
PO BOX 200731, DALLAS, TX 75320-0731
(405) 252-8400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
NULL
Other
Enumeration date
08/10/2005
Last updated
04/07/2025
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