Provider Demographics
NPI:1740828508
Name:TRINITY HOUSECALLS
Entity type:Organization
Organization Name:TRINITY HOUSECALLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHEMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:903-824-6172
Mailing Address - Street 1:4474 SAVAGE STATION DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-1644
Mailing Address - Country:US
Mailing Address - Phone:903-824-6172
Mailing Address - Fax:972-639-3633
Practice Address - Street 1:4474 SAVAGE STATION DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-1644
Practice Address - Country:US
Practice Address - Phone:903-824-6172
Practice Address - Fax:972-639-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty