Provider Demographics
NPI:1235968876
Name:MINTER, TRENTON
Entity type:Individual
Prefix:
First Name:TRENTON
Middle Name:
Last Name:MINTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TRENTON
Other - Middle Name:
Other - Last Name:MINTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 717
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:TX
Mailing Address - Zip Code:75551-0717
Mailing Address - Country:US
Mailing Address - Phone:903-792-2060
Mailing Address - Fax:866-583-6483
Practice Address - Street 1:402 N MCCOY BLVD
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:TX
Practice Address - Zip Code:75570-2300
Practice Address - Country:US
Practice Address - Phone:903-792-2060
Practice Address - Fax:866-583-6483
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor