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General NPI Number Information
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NPI Number | 1538321088
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Entity Type | Individual
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Provider Name | BETH A. TREVINO MD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 1702 LAFAYETTE ST. GCHC WEST CLINIC
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City | LAREDO
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State | TX
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Zip | 78041
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Country | US
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Telephone | 956-795-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 LAFAYETTE ST. GCHC WEST CLINIC
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City | LAREDO
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State | TX
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Zip | 78041
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Country | US
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Telephone | 956-795-8100
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Fax |
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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 | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | A99175
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 47066
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | P8090
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License Number State | TX
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