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NPI Code Detail

MEDICARE: TRINITY CLINIC

MEDICARE: TRINITY CLINIC
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1528297983
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRINITY CLINIC
Provider Business Mailing Address
First Line : PO BOX 846098
Second Line :
City : DALLAS
State : TX
Zip : 75284-6098
Country : US
Telephone Number : 903-324-6400
Fax Number :
Provider Business Practice Location Address
First Line : 20208 STATE HIGHWAY 155 S
Second Line :
City : FLINT
State : TX
Zip : 75762-5600
Country : US
Telephone Number : 903-825-6222
Fax Number :
Authorized Official
Title or Position : PROVIDER ENROLLMENT COORDINATOR
Name : MARY ANN HARRISON
Credential : CPC CMC
Telephone Number : 903-510-1113
Provider Enumeration Date : 07/07/2009
Last Update Date : 09/25/2012

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Directions to “TRINITY CLINIC ” Practice Location

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