Physician Compare National (NPI:1134440696)

HEALTHCARE PROVIDER: VICTOR JESUS TREVINO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1134440696
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618105040
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140110001019
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TREVINO
	Individual professional last name
Provider First Name	VICTOR
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LONESTAR HOSPITAL MEDICINE ASSOCIATES PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6709049703
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	95
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2400 ROUND ROCK AVE
	Group Practice or individual's line 1 address
City	ROUND ROCK
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	786814004
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5123411000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450046
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450828
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHRISTUS SPOHN HOSPITAL ALICE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450163
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	CHRISTUS SPOHN HOSPITAL KLEBERG
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y