Organization
C-TRILOGY COMPREHENSIVE CLINICAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY HICKS (OWNER)
(903) 234-8755
Entity
Organization
Contact information
Practice address
618 N HIGH ST STE 3, LONGVIEW, TX 75601-5377
(903) 234-8755
Mailing address
618 N HIGH ST STE 3, LONGVIEW, TX 75601-5377
(903) 234-8755
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
AP125290
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084816001
—
TX
Enumeration date
12/14/2015
Last updated
11/14/2022
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