MEDICARE: EDWARD WILLIAM TREJO JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	43929	TX

General Provider Information

NPI Number	:	1366398141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD WILLIAM TREJO JR.

Provider Business Mailing Address
First Line	:	1101 N CAMPBELL ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 N CAMPBELL ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4238
Country	:	US
Telephone Number	:	916-747-8519
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “ EDWARD WILLIAM TREJO JR. ” Practice Location

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