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NPI Code Detail

MEDICARE: OCTAVIO TREJO MD

MEDICARE:   OCTAVIO  TREJO  MD
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
1207ZC0500XCytopathology PhysicianK6787TX
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianK6787TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1167289102OTHERTXCIDC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629039623
Entity Type Code : Individual
Provider Name (Legal Business Name) : OCTAVIO TREJO MD
Provider Business Mailing Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-755-8478
Fax Number : 915-755-7333
Provider Business Practice Location Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-755-8478
Fax Number : 915-755-7331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 03/01/2023

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Directions to “ OCTAVIO TREJO MD” Practice Location

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