Organization
TRINITY CLINIC
Active
Other names
HERRINGTON ORNELAS HEALTH PLAZA
Organization subpart
No
Provider details
NPI number
Authorized official
ELIAS D FAJARDO (PROVIDER ENROLLMENT MANAGER)
(903) 510-1113
Entity
Organization
Contact information
Practice address
3593 E GRANDE BLVD, TYLER, TX 75707-1400
(903) 839-2585
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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