MEDICARE: DR TRIPP AND ASSOCIATES -TEXASCOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1275403784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR TRIPP AND ASSOCIATES -TEXASCOR

Provider Business Mailing Address
First Line	:	5473 BLAIR RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4227
Country	:	US
Telephone Number	:	772-494-7770
Fax Number	:	772-258-4480

Provider Business Practice Location Address
First Line	:	5590 NW PINE TRAIL CIRCLE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983
Country	:	US
Telephone Number	:	772-494-7770
Fax Number	:	772-258-4480

Authorized Official
Title or Position	:	CEO
Name	:	SHARDAE C TRIPP
Credential	:
Telephone Number	:	772-494-7770

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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