Provider Demographics
NPI:1780460501
Name:TRINITY BALANCED FAMILY HEALTHCARE LLC
Entity type:Organization
Organization Name:TRINITY BALANCED FAMILY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DORSETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-387-3970
Mailing Address - Street 1:1101 SATELLITE VW
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1586
Mailing Address - Country:US
Mailing Address - Phone:512-733-5800
Mailing Address - Fax:
Practice Address - Street 1:1101 SATELLITE VW
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1586
Practice Address - Country:US
Practice Address - Phone:512-733-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty