Provider Demographics
NPI:1962679530
Name:TRINITY FAMILY HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:TRINITY FAMILY HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:972-424-7000
Mailing Address - Street 1:900 E PARK BLVD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5465
Mailing Address - Country:US
Mailing Address - Phone:972-424-7000
Mailing Address - Fax:
Practice Address - Street 1:900 E PARK BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5465
Practice Address - Country:US
Practice Address - Phone:972-424-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX679911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty