Healthcare Provider Details

I. General information

NPI: 1740486208
Provider Name (Legal Business Name): HECTOR R. TREVINO, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2176 E GARRISON ST STE C
EAGLE PASS TX
78852-5072
US

IV. Provider business mailing address

2176 E GARRISON ST STE C
EAGLE PASS TX
78852-5072
US

V. Phone/Fax

Practice location:
  • Phone: 830-773-3353
  • Fax:
Mailing address:
  • Phone: 830-773-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HECTOR RAUL TREVINO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 830-773-3353