Organization
TRINITY CLINIC
Active
Parent organization
TRINITY CLINIC
Other names
Trinity Clinic Orthopaedics
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRINITY CLINIC
Authorized official
AMY BETH COLLINS CPC (PROVIDER ENROLLMENT LEAD)
(903) 510-1113
Entity
Organization
Contact information
Practice address
1327 TROUP HWY, TYLER, TX 75701-4443
(903) 510-8840
Mailing address
PO BOX 840698, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168206401
—
TX
05
—
168206402
—
TX
Enumeration date
02/19/2008
Last updated
04/20/2015
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