Provider Demographics
NPI:1932529443
Name:TRINA, INC.
Entity Type:Organization
Organization Name:TRINA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-640-9164
Mailing Address - Street 1:420 MAIN ST
Mailing Address - Street 2:APT. 105
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 S MAIN ST
Practice Address - Street 2:APT. 105
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-3900
Practice Address - Country:US
Practice Address - Phone:918-894-8711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1084152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100760760AMedicaid