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General NPI Number Information
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NPI Number | 1790959427
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Entity Type | Individual
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Provider Name | ERIC TREVINO MD
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Gender | Male
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 12700 N FEATHERWOOD DR #260
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City | HOUSTON
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State | TX
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Zip | 77034
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Country | US
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Telephone | 808-312-7849
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Fax |
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Provider Business Mailing Address
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Address Line | 3139 W HOLCOMBE BLVD # A39
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City | HOUSTON
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State | TX
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Zip | 77025-1533
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Country | US
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Telephone | 808-312-7849
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0061149
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M9705
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 60927882
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 16386
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License Number State | HI
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C158890
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License Number State | CA
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