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General NPI Number Information
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NPI Number | 1366173510
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Entity Type | Individual
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Provider Name | MARIO TREVINO RP.H. AND PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 1885 E PRICE RD STE B
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3193
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Country | US
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Telephone | 956-554-3532
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Fax | 956-554-3549
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Provider Business Mailing Address
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Address Line | 1885 E PRICE RD STE B
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3193
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Country | US
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Telephone | 956-554-3532
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Fax | 956-554-3549
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 41631
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License Number State | TX
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