Healthcare Provider Details

I. General information

NPI: 1487076782
Provider Name (Legal Business Name): TRINA MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20007 SPRING WREATH LN
CYPRESS TX
77433-1890
US

IV. Provider business mailing address

20007 SPRING WREATH LN
CYPRESS TX
77433-1890
US

V. Phone/Fax

Practice location:
  • Phone: 909-904-6696
  • Fax:
Mailing address:
  • Phone: 909-904-6696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: