Provider Demographics
NPI:1225003759
Name:TRINITY FOOT CENTER, P.C.
Entity Type:Organization
Organization Name:TRINITY FOOT CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRANDY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:972-293-9650
Mailing Address - Street 1:445 E FM 1382
Mailing Address - Street 2:#3-111
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6047
Mailing Address - Country:US
Mailing Address - Phone:972-293-9650
Mailing Address - Fax:972-291-2533
Practice Address - Street 1:950 E BELT LINE RD
Practice Address - Street 2:#110
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2422
Practice Address - Country:US
Practice Address - Phone:972-293-9650
Practice Address - Fax:972-291-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-19
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180277901Medicaid
TX0005NROtherBLUE SHIELD
TX5887670001Medicare NSC