# EAST TEXAS MEDICAL CENTER TRINITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ETMC Trinity Pro Fees
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467787648
- **Authorized official:** MRS. DANA LAMB (BUSINESS OFFICE DIRECTOR)
- **Authorized official phone:** (936) 546-3810

## Contact information

- **Practice address:** 317 PROSPECT DRIVE, TRINITY, TX 75862
- **Practice address phone:** (936) 744-1100
- **Mailing address:** P O BOX 3169, 315 PROSPECT DRIVE, TRINITY, TX 75862-3169
- **Mailing address phone:** (936) 594-3595
- **Mailing address fax:** (936) 594-0491

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207VG0400X | Gynecology Physician | — | NULL | — |
| 207VG0400X | Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 10/06/2009
- **Last updated:** 12/02/2009