CHRISTUS TRINITY CLINIC (NPI# 1134313083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134313083 |
Entity Type | Organization |
Organization Name | CHRISTUS TRINITY CLINIC |
Other Organization Name | TRINITY CLINIC CANTON |
Practice Address |
18780 Interstate 20 Canton TX 75103-3593 |
Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
Practice Telephone | 9035674841 |
Practice Fax Number | 9035672818 |
Mailing Telephone | 9033246400 |
Enumeration Date | 2007-09-04 |
Last Update Date | 2020-01-10 |
Authorized Official Name | JOHN CHRISTOPHER GLENNEY (VP) |
Authorized Official Telephone | 9036064445 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 063683902 | 05 | |
TX | SUPERIOR HEALTH | 131501 | 01 |
TX | 063683901 | 05 | |
TX | MEDICARE PART A | 673822 | 01 |
Other Name | Type Code |
---|---|
CHRISTUS TRINITY CLINIC CANTON RHC | Doing Business As Name - Organization |
TRINITY CLINIC CANTON | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033641105 | Christus Trinity Clinic | Clinic/Center | 650 E Lennon Dr, Emory, TX 75440-3227 | 2017-03-29 |
1942732011 | Christus Trinity Clinic | Clinic/Center | 105 Medical Plz # II, Sulphur Springs, TX 75482-2136 | 2017-03-29 |
1275727125 | Christus Trinity Clinic | Clinic/Center | 1302 N Pacific St, Mineola, TX 75773-1022 | 2007-09-04 |
1396939146 | Christus Trinity Clinic | Clinic/Center | 5321 S Fm 14, Hawkins, TX 75765-4839 | 2007-09-04 |
1497949341 | Christus Trinity Clinic | Clinic/Center | 502 E Goode St Ste 1e, Quitman, TX 75783-2539 | 2007-09-04 |
1285684225 | Christus Trinity Clinic | Anesthesiology | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2006-05-11 |
Street Address |
18780 INTERSTATE 20 |
City | CANTON |
State | TX |
Zip Code | 75103-3593 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396745758 | Michael Wayne Deeds | Physician Assistant | 18780 Interstate 20, Canton, TX 75103-3593 | 2005-07-28 |
1245657824 | Angela Burrus | Nurse Practitioner | 18780 Interstate 20, Canton, TX 75103-3593 | 2014-03-21 |
1407294101 | Emily Ann Dosier | Family Medicine | 18780 Interstate 20, Canton, TX 75103-3593 | 2013-06-05 |
1649596867 | Georgia Ann Womble | Physician Assistant | 18780 Interstate 20, Canton, TX 75103-3593 | 2010-04-13 |
1467693200 | Sheryl Ann Busch | Internal Medicine | 18780 Interstate 20, Canton, TX 75103-3593 | 2009-03-06 |
1316048994 | Bradford James White | Nurse Practitioner | 18780 Interstate 20, Canton, TX 75103-3593 | 2006-09-26 |
1942218359 | Jerry Wharton Rodgers | Family Medicine | 18780 Interstate 20, Canton, TX 75103-3593 | 2006-08-03 |
1417991340 | Kevin Nixon | Emergency Medicine | 18780 Interstate 20, Canton, TX 75103 | 2006-06-14 |
1841231446 | Virginia Yolanda Gonzalez | Internal Medicine | 18780 Interstate 20, Canton, TX 75103-3593 | 2006-06-08 |
1720052566 | Kenneth Wayne Nixon | Family Medicine | 18780 Interstate 20, Canton, TX 75103-3593 | 2006-02-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265095202 | Brandi Jo Foster | Nurse Practitioner | 4437 Etheride Circle, Canton, TX 75103 | 2019-04-16 |
1124595087 | Melissa Williams | Nurse Practitioner | 1108 So. Buffalo St, Canton, TX 75103 | 2018-10-30 |
1295218667 | Jennifer Elaine Moore | Registered Nurse | 185 Vz Cr 2103, Canton, TX 75103 | 2018-09-12 |
1568945921 | Kelsey Lauren Nixon | Registered Nurse | 5640 Vzcr 4106, Canton, TX 75103 | 2018-09-12 |
1649770496 | Chelsea Boshart | Registered Nurse | 150 Vz Cr 4130, Canton, TX 75103 | 2018-02-19 |
1396292918 | Deanne Wheeler | Hearing Instrument Specialist | 150 E. Dallas Street, Canton, TX 75103 | 2016-09-01 |
1356701221 | Betsy Jill Chappell | Nurse Practitioner | 406 Tx-243, Canton, TX 75103 | 2016-03-04 |
1326435199 | Forever Kids Pediatric Clinic | Clinic/Center | 182 Privatet Road 6413, Canton, TX 75103 | 2015-04-20 |
1417255233 | Dallas County Hospital District | Skilled Nursing Facility | 1901 S Trade Days Blvd, Canton, TX 75103 | 2011-03-02 |
1922243906 | Brookshire Grocery Company | Pharmacy | 880 E State Highway 243, Canton, TX 75103 | 2008-12-05 |
Find all providers in zip 75103 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
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1932144243 | Psp Medical Clinic LLC | Clinic/Center | 1171 Hart St, Canton, MS 39046-4805 | 2006-06-19 |
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1700447950 | Scott & White Hospital - Marble Falls | Clinic/Center | 105 Fm2342, Kingsland, TX 78639-6010 | 2019-06-27 |
1275193005 | Brenham Family Practice and Obstetrics Pa | Clinic/Center | 601 Medical Pkwy Ste D, Brenham, TX 77833-5430 | 2019-06-14 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.