Organization
CHRISTUS TRINITY CLINIC
Active
Other names
TRINITY CLINIC CANTON, CHRISTUS TRINITY CLINIC CANTON RHC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CHRISTOPHER GLENNEY (VP)
(903) 606-4445
Entity
Organization
Contact information
Practice address
18780 INTERSTATE 20, CANTON, TX 75103-3593
(903) 567-4841
(903) 567-2818
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063683901
—
TX
05
—
063683902
—
TX
01
—
131501
SUPERIOR HEALTH
TX
01
—
673822
MEDICARE PART A
TX
Enumeration date
09/04/2007
Last updated
01/10/2020
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