# INTEGRIS BASS BAPTIST HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** INTEGRIS HEALTH MEDICAL GROUP WAYNOKA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124029293
- **Authorized official:** DONNA WALLACE (ASSISTANT TREASURER)
- **Authorized official phone:** (636) 359-4890

## Contact information

- **Practice address:** 1084 NICKERSON ST, WAYNOKA, OK 73860-1245
- **Practice address phone:** (580) 824-2281
- **Mailing address:** PO BOX 200731, DALLAS, TX 75320-0731
- **Mailing address phone:** (405) 252-8400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/10/2005
- **Last updated:** 04/07/2025