| Trinity Clinic Canton | |
|
18780 Interstate 20 Canton TX 75103-3593 | |
| (903) 567-4841 | |
| (903) 567-2818 |
| Full Name | Trinity Clinic Canton |
|---|---|
| Speciality | Clinic/Center |
| Location | 18780 Interstate 20, Canton, Texas |
| Authorized Official Name and Position | John Christopher Glenney (VP) |
| Authorized Official Contact | 9036064445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Clinic Canton Po Box 846098 Dallas TX 75284-6098 Ph: (903) 324-6400 | Trinity Clinic Canton 18780 Interstate 20 Canton TX 75103-3593 Ph: (903) 567-4841 |
| NPI Number | 1134313083 |
|---|---|
| Provider Enumeration Date | 09/04/2007 |
| Last Update Date | 01/10/2020 |
| Medicare PECOS PAC ID | 3072426741 |
|---|---|
| Medicare Enrollment ID | O20090212000727 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134313083 | NPI | - | NPPES |
| 131501 | Other | TX | SUPERIOR HEALTH |
| 673822 | Other | TX | MEDICARE PART A |
| 063683901 | Medicaid | TX | |
| 063683902 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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