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General NPI Number Information
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NPI Number | 1376968800
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Entity Type | Individual
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Provider Name | RUBEN TREVINO
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Gender | Male
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 835 N EXPRESSWAY SUITE A
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6831
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Country | US
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Telephone | 956-544-7722
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Fax | 956-544-7728
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Provider Business Mailing Address
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Address Line | 117 N VALENCIA DR
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City | BAYVIEW
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State | TX
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Zip | 78566
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Country | US
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Telephone | 956-592-7100
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Fax | 956-544-7728
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 21423
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License Number State | TX
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