Individual
IDALIA ALICIA TREVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210 W DEL MAR BLVD, LAREDO, TX 78041-2205
(956) 712-3251
Mailing address
210 W DEL MAR BLVD, LAREDO, TX 78041-2205
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
100954
TX
Other
Enumeration date
03/03/2021
Last updated
03/03/2021
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