Organization
CHRISTUS TRINITY CLINIC
Active
Other names
CHRISTUS TRINITY CLINIC HOLLY LAKE
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CHRISTOPHER GLENNEY (VP)
(903) 606-4445
Entity
Organization
Contact information
Practice address
5321 S FM 14, HAWKINS, TX 75765-4839
(903) 769-2990
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
01
—
143621
SUPERIOR HEALTH
TX
05
—
179427301
—
TX
01
—
673886
MEDICARE PART A
TX
Enumeration date
09/04/2007
Last updated
01/10/2020
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