Organization
HENRY T HORRILLENO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY T HORRILLENO MD (PHYSICIAN OWNER)
(580) 225-4200
Entity
Organization
Contact information
Practice address
1800 W 1ST ST, SUITE 108, ELK CITY, OK 73644-3133
(580) 225-4200
(580) 225-4201
Mailing address
1800 W 1ST ST, SUITE 108, ELK CITY, OK 73644-3133
(580) 225-4200
(580) 225-4201
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25632
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200115760A
—
OK
Enumeration date
07/06/2007
Last updated
06/02/2008
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