Organization
TRINITY CLINIC
Active
Other names
Trinity Clinic Henderson
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN HARRISON CPC, CMC (PHYSICIAN CLINIC SUPPORT COORDINATO)
(903) 510-1113
Entity
Organization
Contact information
Practice address
500 N. MARSHALL, HENDERSON, TN 75652
(903) 657-1653
Mailing address
PO BOX 5500, TYLER, TX 75712
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138737503
—
TX
Enumeration date
05/11/2006
Last updated
07/07/2022
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