Trinity Clinic

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TRINITY CLINIC

Doing business as

Trinity Clinic Reference Laboratory

Practice address

3200 Troup Hwy
Ste 110
Tyler, TX 75701-8359

Phone

(903) 510-1125

NPI assigned

Apr 16, 2007

Last updated

Jun 30, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

TRINITY CLNICAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Ann Harrison, CPC CMC

Title

Provider Enrollment Coordinator

Phone

(903) 510-1113

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Trinity Clinic Reference Laboratory Doing business as

Part of

Tyler Radiologist

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1679798714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5500",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757125500",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 TROUP HWY",
            "address_2": "STE 110",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018359",
            "telephone_number": "903-510-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY CLNIC",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "903-510-1113",
        "authorized_official_credential": "CPC  CMC"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025522601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "H0CL831301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Clinic Reference Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trinity Clinic
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• Trinity Clinic (Trinity Clinic NeuroSurgery)
• Trinity Clinic (Trinity Rehab)
• Trinity Clinic (Trinity Clinic Surgery)
• Trinity Clinic
• Trinity Clinic (Trinity Clinic MultiSpecialty Group)
• Trinity Clinic (Herrington Ornelas Health Plaza)
• Trinity Clinic (Trinity Clinic Family Practice)
• Trinity Clinic (Trinity Clinic Podiatry)

• Clinical Medical Laboratory in Tyler, TX
• Providers in Tyler, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.