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General NPI Number Information
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NPI Number | 1740465186
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Entity Type | Individual
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Provider Name | TEODORO TREVINO JR. O.T.R.
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Gender | Male
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 613 W SESAME DR
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City | HARLINGEN
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State | TX
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Zip | 78550-7930
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Country | US
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Telephone | 956-399-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 221 MORELOS AVE
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City | RANCHO VIEJO
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State | TX
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Zip | 78575-9514
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Country | US
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Telephone | 956-621-0376
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 111870
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License Number State | TX
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