# TRINITY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRINITY CLINIC
- **Other names:** Trinity Clinic Kilgore
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376593335
- **Legal business name:** TRINITY CLINIC
- **Authorized official:** MARY A HARRISON CPC CMC (PHYSICIAN CLINIC SUPPORT COORD)
- **Authorized official phone:** (903) 510-1113

## Contact information

- **Practice address:** 1718 S HENDERSON BLVD, KILGORE, TX 75662-3566
- **Practice address phone:** (903) 983-2110
- **Practice address fax:** (903) 986-9148
- **Mailing address:** PO BOX 5500, TYLER, TX 75712-5500
- **Mailing address phone:** (903) 324-6400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/11/2006
- **Last updated:** 06/03/2008