Organization
TRINITY CLINIC
Active
Parent organization
TRINITY CLINIC
Other names
Trinity Clinic Douglas Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRINITY CLINIC
Authorized official
MARY ANN HARRISON CPC CMC (PROVIDER ENROLLMENT COORDINATOR)
90351011113
Entity
Organization
Contact information
Practice address
520 E DOUGLAS BLVD, TYLER, TX 75702-8307
(903) 593-1721
Mailing address
PO BOX 840698, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/13/2009
Last updated
04/20/2015
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