Individual
TRINA S CORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1901 NORTH HWY 87, BIG SPRING, TX 79720
(409) 789-5343
Mailing address
5709 FRUITLAND FARM RD, SAN ANGELO, TX 76903-1042
(409) 789-5343
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
K2150
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117746105
—
TX
Enumeration date
07/25/2006
Last updated
10/18/2012
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