| Trinity Heritage Pllc | |
|
2204 Joe Battle Blvd # D203 El Paso TX 79938-4660 | |
| (817) 966-3226 | |
| Not Available |
| Full Name | Trinity Heritage Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2204 Joe Battle Blvd # D203, El Paso, Texas |
| Authorized Official Name and Position | Victor Nwiloh (MD) |
| Authorized Official Contact | 8179663226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Heritage Pllc Po Box 963207 El Paso TX 79996-3207 Ph: (817) 966-3226 | Trinity Heritage Pllc 2204 Joe Battle Blvd # D203 El Paso TX 79938-4660 Ph: (817) 966-3226 |
| NPI Number | 1851852297 |
|---|---|
| Provider Enumeration Date | 03/28/2019 |
| Last Update Date | 11/18/2019 |
| Medicare PECOS PAC ID | 8729319793 |
|---|---|
| Medicare Enrollment ID | O20191007002214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851852297 | NPI | - | NPPES |
| 1851338032 | Other | TX | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Victor M Nwiloh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851338032 PECOS PAC ID: 1658354832 Enrollment ID: I20130618000583 |
| Provider Name | Mariagorety O Nwiloh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740604560 PECOS PAC ID: 1951527308 Enrollment ID: I20140722000232 |
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