Provider Demographics
NPI:1528334067
Name:TRINITY FAMILY HEALTH CLINIC LLC
Entity type:Organization
Organization Name:TRINITY FAMILY HEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EBERECHI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-544-3556
Mailing Address - Street 1:777 S CENTRAL EXPY
Mailing Address - Street 2:5H
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-7411
Mailing Address - Country:US
Mailing Address - Phone:469-544-3556
Mailing Address - Fax:972-212-4549
Practice Address - Street 1:777 S CENTRAL EXPY
Practice Address - Street 2:5H
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-7411
Practice Address - Country:US
Practice Address - Phone:469-544-3556
Practice Address - Fax:972-212-4549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty