Provider Demographics
NPI:1821392606
Name:TRINCARE INC
Entity Type:Organization
Organization Name:TRINCARE INC
Other - Org Name:TRINITY OPTICAL LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-525-2993
Mailing Address - Street 1:1327 TROUP HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-4443
Mailing Address - Country:US
Mailing Address - Phone:903-525-2993
Mailing Address - Fax:903-531-5853
Practice Address - Street 1:2026 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-5822
Practice Address - Country:US
Practice Address - Phone:903-589-7031
Practice Address - Fax:903-586-4528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center