Organization
TRINITY SPINE AND ORTHOPEDICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY M KJELDGAARD DO (OWNER / PRESIDENT)
(817) 283-5252
Entity
Organization
Contact information
Practice address
4444 HERITAGE TRACE, SUITE 408, KELLER, TX 76244
(817) 283-5252
(817) 283-5283
Mailing address
4444 HERITAGE TRACE, SUITE 408, KELLER, TX 76244
(817) 283-5252
(817) 283-5283
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H3398
TEXAS MEDICAL LICENSE
TX
Enumeration date
06/16/2020
Last updated
06/16/2020
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