Provider Demographics
NPI:1194273870
Name:TRINTIY CATH LAB LLC
Entity type:Organization
Organization Name:TRINTIY CATH LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:VON
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WOROSYLLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-904-8888
Mailing Address - Street 1:1018 E WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4914
Mailing Address - Country:US
Mailing Address - Phone:469-904-8888
Mailing Address - Fax:469-513-2385
Practice Address - Street 1:1018 E WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4914
Practice Address - Country:US
Practice Address - Phone:469-904-8888
Practice Address - Fax:469-513-2385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty