Provider Demographics
NPI:1114426269
Name:TRINITY HOME VISITING DOCTORS PLLC
Entity type:Organization
Organization Name:TRINITY HOME VISITING DOCTORS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VENKATA
Authorized Official - Middle Name:
Authorized Official - Last Name:YETURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-677-7964
Mailing Address - Street 1:2735 VILLA CREEK DR STE A143
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7454
Mailing Address - Country:US
Mailing Address - Phone:972-677-7964
Mailing Address - Fax:972-677-7794
Practice Address - Street 1:2735 VILLA CREEK DR STE A143
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-7454
Practice Address - Country:US
Practice Address - Phone:972-677-7964
Practice Address - Fax:972-677-7794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty