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General NPI Number Information
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NPI Number | 1932246758
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Entity Type | Organization
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Legal Business Name | RAUL A. TREVINO OD PA
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 2210 NW MILITARY HWY
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City | SAN ANTONIO
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State | TX
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Zip | 78213-1815
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Country | US
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Telephone | 210-344-1400
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Fax | 210-342-2039
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Provider Business Mailing Address
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Address Line | 2210 NW MILITARY HWY
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City | SAN ANTONIO
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State | TX
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Zip | 78213-1890
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Country | US
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Telephone | 210-344-1400
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Fax | 210-342-2039
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Authorized Official
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Title or Position | CONSULTANT
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Name | EUDE A OSSORIO
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Credential | CONSULTANTS
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Telephone | 832-934-1166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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