TRINITY CLINIC (NPI# 1366671216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366671216 |
| Entity Type | Organization |
| Organization Name | TRINITY CLINIC |
| Other Organization Name | TRINITY CLINIC DOUGLAS PRIMARY CARE |
| Practice Address |
520 E Douglas Blvd Tyler TX 75702-8307 |
| Mailing Address |
Po Box 840698 Dallas TX 75284-6098 |
| Practice Telephone | 9035931721 |
| Mailing Telephone | 9033246400 |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2015-04-20 |
| Authorized Official Name | MARY ANN HARRISON (PROVIDER ENROLLMENT COORDINATOR) |
| Authorized Official Telephone | 90351011113 |
| Authorized Official Credential | CPC CMC |
| Is Organization Subpart | Y |
| Parent Organization Name | TRINITY CLINIC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Trinity Clinic Douglas Primary Care | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982936936 | Trinity Clinic | Clinic/Center | 500 N Marshall St, Henderson, TX 75652-5932 | 2010-02-02 |
| 1982859377 | Trinity Clinic | Clinic/Center | 803 Hwy 31 East, Chandler, TX 75758-0373 | 2008-11-26 |
| 1942455654 | Trinity Clinic | Clinic/Center | 1505 Hwy 19 South, Athens, TX 75751-8950 | 2008-11-21 |
| 1144493107 | Trinity Clinic | Clinic/Center | 866 E. Lennon Dr, Ste 105, Emory, TX 75440-3214 | 2008-04-10 |
| 1922276435 | Trinity Clinic | Podiatrist | 1034 Clinic Dr, Tyler, TX 75701-2050 | 2008-02-19 |
| 1427245166 | Trinity Clinic | Clinic/Center | 175 Spur 3007, Scroggins, TX 75480-6403 | 2007-09-26 |
| 1760676613 | Trinity Clinic | Clinic/Center | 511 N High St, Henderson, TX 75652-5985 | 2007-09-04 |
| 1174742902 | Trinity Clinic | Chiropractor | 4236 Nw Expressway St, Suite 118, Oklahoma City, OK 73116-1588 | 2007-04-24 |
| 1861618779 | Trinity Clinic | Clinic/Center | 307 Woodlawn, Kilgore, TX 75662-3624 | 2007-04-18 |
| 1558399592 | Trinity Clinic | Anesthesiology | 800 East Dawson St, Tyler, TN 75701 | 2006-06-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TRINITY CLINICAL CONSULTING GROUP, LLC | 285 S Englewood Dr, Baton Rouge, LA 70810-5004 |
| Street Address |
520 E DOUGLAS BLVD |
| City | TYLER |
| State | TX |
| Zip Code | 75702-8307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316917750 | David H Beaird | Internal Medicine | 520 E Douglas Blvd, Tyler, TX 75702-8307 | 2006-01-26 |
| 1487973350 | Rebecca L Monahan | Dietitian, Registered | 520 E Douglas Blvd, Tyler, TX 75702-8307 | 2010-05-18 |
| 1619152139 | Amanda Elizabeth Mullins | Nurse Practitioner | 520 E Douglas Blvd, Tyler, TX 75702-8307 | 2008-01-03 |
| 1225162753 | Robert Brooks Clarke | Physician Assistant | 520 E Douglas Blvd, Tyler, TX 75702-8307 | 2007-03-15 |
| 1356364178 | Neda Esfandiari | Family Medicine | 520 E Douglas Blvd, Tyler, TX 75702-8307 | 2006-07-25 |
| 1316966971 | Albert C Lee | Specialist | 520 E Douglas Blvd, Tyler, TX 75702-8307 | 2006-07-18 |
| 1134163868 | Marcia W Green | Nurse Practitioner | 520 E Douglas Blvd, Tyler, TX 75702-8307 | 2006-06-15 |
| 1407896293 | Andria Beth Cardinalli-stein | Internal Medicine | 520 E Douglas Blvd, Tyler, TX 75702-8307 | 2006-06-08 |
| 1649246315 | James Gregory Stovall | Internal Medicine | 520 E Douglas Blvd, Tyler, TX 75702 | 2006-02-23 |
| 1245206937 | Oscar Ray Wilson | Family Medicine | 520 E Douglas Blvd, Tyler, TX 75702-8307 | 2006-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699315499 | East Texas Family Support Clinic | Clinic/Center | 1305 Doctors Dr, Tyler, TX 75701-2263 | 2020-01-09 |
| 1497992846 | Cardiac Cath Lab of Tyler Lp | Clinic/Center | 1769 Troup Hwy, Tyler, TX 75701 | 2009-01-07 |
| 1851839120 | Trinity Clinic | Clinic/Center | 3593 E Grande Blvd, Tyler, TX 75707-1400 | 2017-02-07 |
| 1366680217 | Trinity Clinic | Clinic/Center | 910 E Houston St, Ste 330, Tyler, TX 75702-8368 | 2009-01-30 |
| 1659516086 | Trinity Clinic | Clinic/Center | 910 E Houston St, Ste 550, Tyler, TX 75702-8366 | 2008-12-15 |
| 1487807277 | Trinity Clinic | Clinic/Center | 3131 Troup Hwy, Tyler, TX 75701-8350 | 2008-10-24 |
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| 1770107856 | Vascular Institute of Houston Pllc | Clinic/Center | 815 Brazos St Ste 500, Austin, TX 78701-2509 | 2020-06-03 |
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| 1407476138 | Summit Emergency Medicine, Pllc | Clinic/Center | 8111 Lbj Fwy Ste 475, Dallas, TX 75251-1386 | 2020-04-22 |
| 1174143002 | Ultimate Pain Solutions, P.l.l.c. | Clinic/Center | 9700 Richmond Ave Ste 120, Houston, TX 77042-4697 | 2020-04-21 |
| 1376163311 | Betts Ventures Inc | Clinic/Center | 13134 Dairy Ashford Rd Ste 900-a, Sugar Land, TX 77478-3756 | 2020-04-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.