Healthcare Provider Details

I. General information

NPI: 1588529069
Provider Name (Legal Business Name): DELTA HEALTH & PERFORMANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E CANO ST STE 133
EDINBURG TX
78539-4510
US

IV. Provider business mailing address

204 E CANO ST STE 133
EDINBURG TX
78539-4510
US

V. Phone/Fax

Practice location:
  • Phone: 956-828-7501
  • Fax:
Mailing address:
  • Phone: 956-828-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MIGUEL TREVINO
Title or Position: MANAGING MEMBER
Credential: MS, RDN, LD
Phone: 956-828-7501