Organization
TEXOMACARE SPECIALTY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD EVANS (VP)
(610) 768-3300
Entity
Organization
Contact information
Practice address
5012 S US HIGHWAY 75, SUITE 100, DENISON, TX 75020-4587
(903) 416-1726
Mailing address
5012 US HWY 75 S, SUITE 300, ATT: BILLING, DENISON, TX 75020
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
TX
207RI0011X
Interventional Cardiology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
TX
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200424690
—
OK
05
—
315265401
—
TX
Enumeration date
09/01/2011
Last updated
06/28/2019
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