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NPI Code Detail

MEDICARE: DR. CHRISTINE ANN TREVINO DO

MEDICARE: DR. CHRISTINE ANN TREVINO DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianN4419TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164626727
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINE ANN TREVINO DO
Provider Business Mailing Address
First Line : 2423 WILLIAMS DR STE 107
Second Line :
City : GEORGETOWN
State : TX
Zip : 78628-3269
Country : US
Telephone Number : 877-800-5722
Fax Number :
Provider Business Practice Location Address
First Line : 605 OLD AUSTIN HWY
Second Line :
City : BASTROP
State : TX
Zip : 78602-5034
Country : US
Telephone Number : 512-308-6894
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2007
Last Update Date : 07/17/2025

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