Provider Demographics
NPI:1710126230
Name:TROTTER, CLAUDE RUSSELL III
Entity Type:Individual
Prefix:MRS
First Name:CLAUDE
Middle Name:RUSSELL
Last Name:TROTTER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 543491
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-3491
Mailing Address - Country:US
Mailing Address - Phone:214-924-8164
Mailing Address - Fax:
Practice Address - Street 1:674 W WARRIOR TRL
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-6099
Practice Address - Country:US
Practice Address - Phone:214-924-8164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor