C-TRILOGY COMPREHENSIVE CLINICAL CARE (NPI# 1730554999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730554999 |
Entity Type | Organization |
Organization Name | C-TRILOGY COMPREHENSIVE CLINICAL CARE |
Practice Address |
104 Rothrock Dr Suite A Longview TX 75602-1528 |
Practice Telephone | 9035762629 |
Mailing Telephone | 9035762629 |
Enumeration Date | 2015-12-14 |
Last Update Date | 2015-12-15 |
Authorized Official Name | TRACY HICKS (OWNER) |
Authorized Official Telephone | 9035762629 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
AP125290 | TX | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 084816001 | 05 |
Street Address |
104 ROTHROCK DR SUITE A |
City | LONGVIEW |
State | TX |
Zip Code | 75602-1528 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083150569 | Mcet-longview | Clinic/Center | 505 North Sixth Street, Longview, TX 75602 | 2017-01-09 |
1962561597 | Robert Lee Harper | Dentist | 1002 So M L King Jr Blvd, Longview, TX 75602 | 2006-12-08 |
1033202700 | Hervey & Bethard Inc. | Durable Medical Equipment & Medical Supplies | 1900 S. High St., Longview, TX 75602 | 2006-10-02 |
1023426665 | Longview Wellness Center, Inc | Clinic/Center | 2131 S Mobberly Ave, Longview, TX 75602 | 2014-07-28 |
1063748796 | Jeffery Michael Stowers | Pharmacist | 1900 S High St, Longview, TX 75602 | 2009-10-31 |
1326541368 | Tonie Elaine Bryant | Licensed Vocational Nurse | 1006 Flanagan Dr, Longview, TX 75602-1013 | 2018-03-15 |
1285145839 | Maria Tran | Specialist/Technologist | 16 Covington Dr, Longview, TX 75602-1071 | 2017-10-21 |
1639635444 | G and T Young At Heart | Counselor | 1012 E Cotton St, Longview, TX 75602-1322 | 2019-02-17 |
1982020038 | Julie A Dollison | Perfusionist | 301 S Club Dr, Longview, TX 75602-1511 | 2014-03-13 |
1881009231 | Brandi Mccracken | Specialist/Technologist, Other | 301 S Club Dr, Longview, TX 75602-1511 | 2014-06-24 |
Find all providers in zip 75602 |
Taxonomy Code | 364SP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972937316 | Tricia G. Green | Clinical Nurse Specialist | 907 Kincaid Pl, Longview, TX 75604 | 2013-08-21 |
1801300165 | Laurie Ann Womack | Clinical Nurse Specialist | 1615 Delaware St, Longview, WA 98632-2367 | 2017-11-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710599204 | Angeline Ngwe Taboh | Clinical Nurse Specialist | 2944 Marco Dr, Grand Prairie, TX 75052-8724 | 2020-08-18 |
1578173738 | Hope Health Services, LLC | Clinical Nurse Specialist | 19902 Roycroft Ln, Richmond, TX 77407-4000 | 2020-08-03 |
1710384631 | Mental Health Professionals of San Antonio | Clinical Nurse Specialist | 1703 N Loop 1604 W Apt 1203, San Antonio, TX 78258-4679 | 2014-11-20 |
1801185301 | Horizon Senior Care Inc | Clinical Nurse Specialist | 229 Bradfield Ln, Rockwall, TX 75087-9272 | 2011-04-05 |
1518264696 | Abigail E Lopez | Clinical Nurse Specialist | 4225 Camelot Heights Dr., El Paso, TX 79912-2702 | 2011-02-25 |
1558506675 | Lynn Veronica Heselton | Clinical Nurse Specialist | 203 Lorine St, Keller, TX 76248-3434 | 2008-12-03 |
1851558266 | Alfredo Arellano | Clinical Nurse Specialist | 1122 Montana Ave Ste A, El Paso, TX 79902-5510 | 2008-05-22 |
1881870244 | Steffani L Powell | Clinical Nurse Specialist | 100 Bunny Run Ln, Horseshoe Bay, TX 78657-6188 | 2008-01-16 |
1841481595 | Judith Elaine Wessely | Clinical Nurse Specialist | 27115 Trinity Hts, Apt 1025, San Antonio, TX 78261-2430 | 2007-08-07 |
1649490665 | Shannon Wilson Graham | Clinical Nurse Specialist | 400 Quail Creek Dr, Del Rio, TX 78840-2133 | 2007-05-01 |
Find all providers with the same taxonomy |
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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.