| Trinity Salem Family Health Clinic, Pllc | |
|
1007 Legacy Ranch Rd Ste 102 Waxahachie TX 75165-1294 | |
| (336) 341-9295 | |
| Not Available |
| Full Name | Trinity Salem Family Health Clinic, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1007 Legacy Ranch Rd Ste 102, Waxahachie, Texas |
| Authorized Official Name and Position | Yaminah Matthews (OWNER., AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9726668111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Salem Family Health Clinic, Pllc 1007 Legacy Ranch Rd Ste 102 Waxahachie TX 75165-1294 Ph: (972) 666-8111 | Trinity Salem Family Health Clinic, Pllc 1007 Legacy Ranch Rd Ste 102 Waxahachie TX 75165-1294 Ph: (336) 341-9295 |
| NPI Number | 1760119440 |
|---|---|
| Provider Enumeration Date | 08/03/2022 |
| Last Update Date | 02/24/2023 |
| Medicare PECOS PAC ID | 1153799572 |
|---|---|
| Medicare Enrollment ID | O20221116001017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760119440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Yaminah Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346679842 PECOS PAC ID: 3375771629 Enrollment ID: I20220427001453 |
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