| Trinity Clinic Douglas Primary Care | |
|
520 E Douglas Blvd Tyler TX 75702-8307 | |
| (903) 593-1721 | |
| Not Available |
| Full Name | Trinity Clinic Douglas Primary Care |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 520 E Douglas Blvd, Tyler, Texas |
| Authorized Official Name and Position | Mary Ann Harrison (PROVIDER ENROLLMENT COORDINATOR) |
| Authorized Official Contact | 90351011113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Clinic Douglas Primary Care Po Box 840698 Dallas TX 75284-6098 Ph: (903) 324-6400 | Trinity Clinic Douglas Primary Care 520 E Douglas Blvd Tyler TX 75702-8307 Ph: (903) 593-1721 |
| NPI Number | 1366671216 |
|---|---|
| Provider Enumeration Date | 07/13/2009 |
| Last Update Date | 04/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366671216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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