Organization
TRINITY CLINIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN HARRISON CMC, CPC (PHYSICIAN CLINIC SUPPORT COORDINATO)
(903) 510-1113
Entity
Organization
Contact information
Practice address
910 E HOUSTON ST STE 550, TYLER, TX 75702-8366
(903) 592-7393
(903) 597-7538
Mailing address
PO BOX 5500, TYLER, TX 75712
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208200000X
Plastic Surgery Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208800000X
Urology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
213E00000X
Podiatrist
—
—
231H00000X
Audiologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T69U
MEDICARE GROUP NUMBER
TX
Enumeration date
09/11/2006
Last updated
09/11/2025
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