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Individual
JUAN JOSE TREVINO
Active
Individual
JUAN JOSE TREVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E4726
TX
207V00000X
Obstetrics & Gynecology Physician
E4726
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118685003
—
TX
01
—
118685004
CSHCN
TX
01
—
8AP823
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/23/2006
Last updated
06/02/2011
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