MEDICARE: DR. TREVOR KYLE HUBER D.O.

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	207Q00000X	Family Medicine Physician	BP10048770	TX
2	207Q00000X	Family Medicine Physician	Q7559	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Q7559	OTHER	TX	STATE LICENSE
2	B0226719	OTHER	TX	DPS

General Provider Information

NPI Number	:	1649682857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TREVOR KYLE HUBER D.O.

Provider Business Mailing Address
First Line	:	10412 MAX LN
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-5204
Country	:	US
Telephone Number	:	972-987-0458
Fax Number	:	972-695-8811

Provider Business Practice Location Address
First Line	:	2700 E ELDORADO PKWY STE 108
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-5999
Country	:	US
Telephone Number	:	972-987-0458
Fax Number	:	972-695-8811

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

Provider Enumeration Date	:	05/21/2014
Last Update Date	:	03/07/2023

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Directions to “ DR. TREVOR KYLE HUBER D.O.” Practice Location

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