Provider Demographics
NPI:1942732011
Name:CHRISTUS TRINITY CLINIC
Entity Type:Organization
Organization Name:CHRISTUS TRINITY CLINIC
Other - Org Name:CHRISTUS TRINITY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CMO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KEUER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-606-4445
Mailing Address - Street 1:520 E DOUGLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-8307
Mailing Address - Country:US
Mailing Address - Phone:903-593-1721
Mailing Address - Fax:903-606-4553
Practice Address - Street 1:105 MEDICAL PLZ # II
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2136
Practice Address - Country:US
Practice Address - Phone:903-885-3181
Practice Address - Fax:903-885-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health