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General NPI Number Information
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NPI Number | 1285889410
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Entity Type | Organization
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Legal Business Name | RICARDO S. TREVINO
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 1212 N MEADOW AVE
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City | LAREDO
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State | TX
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Zip | 78040-5350
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Country | US
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Telephone | 956-286-6870
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Fax | 956-712-0016
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Provider Business Mailing Address
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Address Line | 1212 N MEADOW AVE
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City | LAREDO
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State | TX
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Zip | 78040-5350
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Country | US
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Telephone | 956-286-6870
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Fax | 956-712-0016
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICARDO S TREVINO
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Credential |
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Telephone | 956-712-4596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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