Provider Demographics
NPI:1205689452
Name:CLINICA TRINIDAD, PLLC
Entity type:Organization
Organization Name:CLINICA TRINIDAD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:956-490-9190
Mailing Address - Street 1:6708 W MILE 7 RD
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-0062
Mailing Address - Country:US
Mailing Address - Phone:956-490-9190
Mailing Address - Fax:956-702-3606
Practice Address - Street 1:6708 W MILE 7 RD
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-0062
Practice Address - Country:US
Practice Address - Phone:956-490-9190
Practice Address - Fax:956-702-3606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty