MEDICARE: ELIZA TREVINO-BEENE MD

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	208000000X	Pediatrics Physician	L6682	TX

General Provider Information

NPI Number	:	1750312138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZA TREVINO-BEENE MD

Provider Business Mailing Address
First Line	:	20523 BOBIGIAN DR
Second Line	:
City	:	PORTER
State	:	TX
Zip	:	77365-7207
Country	:	US
Telephone Number	:	832-233-6587
Fax Number	:	713-518-1108

Provider Business Practice Location Address
First Line	:	800 PEAKWOOD DR STE 6F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2903
Country	:	US
Telephone Number	:	281-444-1600
Fax Number	:	713-518-1108

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	01/25/2023

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