| Texomacare | |
|
500 Brookside Dr Madill OK 73446-3643 | |
| (580) 795-5506 | |
| (580) 795-5145 |
| Full Name | Texomacare |
|---|---|
| Speciality | Family Medicine |
| Location | 500 Brookside Dr, Madill, Oklahoma |
| Authorized Official Name and Position | Todd Evans (VP) |
| Authorized Official Contact | 6107683300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Texomacare 5012 Us Hwy 75 S, Suite 300 Att: Billing Denison TX 75020 Ph: (903) 416-1726 | Texomacare 500 Brookside Dr Madill OK 73446-3643 Ph: (580) 795-5506 |
| NPI Number | 1407800857 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 06/28/2019 |
| Medicare PECOS PAC ID | 3678555307 |
|---|---|
| Medicare Enrollment ID | O20040624000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407800857 | NPI | - | NPPES |
| CH3977 | Other | OK | RR MEDICARE |
| 100754740A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 363A00000X | Physician Assistant | () | Secondary |
| Provider Name | Ralph Tillman Falconer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932130150 PECOS PAC ID: 5890782478 Enrollment ID: I20040427000311 |
| Provider Name | Jeffrey F Hamblin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497883789 PECOS PAC ID: 7517947856 Enrollment ID: I20040728001513 |
| Provider Name | Roy K Rogers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548396096 PECOS PAC ID: 3870573116 Enrollment ID: I20040728001537 |
| Provider Name | Shannon Beth Goodwin Chambers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508802216 PECOS PAC ID: 6406921832 Enrollment ID: I20100611000602 |
| Provider Name | Monica M Mclaren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831400506 PECOS PAC ID: 5597930735 Enrollment ID: I20111216000059 |
| Provider Name | Jason S Squires |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982640116 PECOS PAC ID: 6305970500 Enrollment ID: I20180111000264 |
| Provider Name | Ely R Gordon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215992029 PECOS PAC ID: 7517869282 Enrollment ID: I20180123002003 |
| Provider Name | Diego F. Restrepo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063664076 PECOS PAC ID: 7618018615 Enrollment ID: I20180516001517 |
| Provider Name | Athena Todd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811403553 PECOS PAC ID: 7618232752 Enrollment ID: I20180521001505 |
| Provider Name | Quyen N Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003221441 PECOS PAC ID: 4486914165 Enrollment ID: I20210608002007 |
| Provider Name | Sarah Mccutcheon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902349111 PECOS PAC ID: 0648552893 Enrollment ID: I20211019003430 |
| Provider Name | Patricia K Short |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932336898 PECOS PAC ID: 5496885972 Enrollment ID: I20230301000721 |
| Provider Name | April K Mcclafferty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164159422 PECOS PAC ID: 1456725480 Enrollment ID: I20230415000013 |
| Provider Name | Jessica Kent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104542851 PECOS PAC ID: 9436529716 Enrollment ID: I20230504001122 |
| Provider Name | Lauren R Elliott |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427566272 PECOS PAC ID: 6305107186 Enrollment ID: I20240621001660 |
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