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General NPI Number Information
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NPI Number | 1588398127
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Entity Type | Organization
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Legal Business Name | CHRISTUS TRINITY CLINIC
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 1424 E FRONT ST
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City | TYLER
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State | TX
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Zip | 75702-8501
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Country | US
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Telephone | 903-595-4144
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Fax | 903-569-9974
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Provider Business Mailing Address
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Address Line | PO BOX 846098
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City | DALLAS
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State | TX
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Zip | 75284-6098
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Country | US
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Telephone | 903-324-6450
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Fax |
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Authorized Official
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Title or Position | VP, CFO
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Name | MR. ROBERT KARL
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Credential | CPA, MPA
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Telephone | 469-282-2611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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