Provider Demographics
NPI:1437560323
Name:TREVINO, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
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 1:4626 COUNTY ROAD 4206
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:TX
Mailing Address - Zip Code:75422-1246
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4626 COUNTY ROAD 4206
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:TX
Practice Address - Zip Code:75422-1246
Practice Address - Country:US
Practice Address - Phone:903-259-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program