Provider Demographics
NPI:1295239432
Name:TREVINO, LILIAN MERCEDES
Entity type:Individual
Prefix:
First Name:LILIAN
Middle Name:MERCEDES
Last Name:TREVINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 W HALL ACRES RD APT 9B
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5071
Mailing Address - Country:US
Mailing Address - Phone:956-867-0597
Mailing Address - Fax:956-686-7391
Practice Address - Street 1:1011 SYCAMORE AVE # F
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4145
Practice Address - Country:US
Practice Address - Phone:956-867-0597
Practice Address - Fax:956-686-7391
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251G00000XAgenciesHospice Care, Community Based