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General NPI Number Information
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NPI Number | 1134691744
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Entity Type | Organization
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Legal Business Name | TRINITY GERIATRICS PA
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Dates
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Enumeration Date | 12/20/2018
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 11901 SHADOW CREEK PKWY STE 111
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City | PEARLAND
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State | TX
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Zip | 77584-7346
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Country | US
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Telephone | 281-760-1971
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Fax | 888-257-3780
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Provider Business Mailing Address
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Address Line | 11901 SHADOW CREEK PKWY STE 111
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City | PEARLAND
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State | TX
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Zip | 77584-7346
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Country | US
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Telephone | 281-760-1971
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Fax | 888-257-3780
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Authorized Official
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Title or Position | CEO
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Name | DR. DANIEL OBI-OFODILE
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Credential | MD
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Telephone | 281-760-1971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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