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Individual

MR. THADEO GONZALES TRIVILEGIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ASCPI,CM

Contact information

Practice address
100 W CROSS ST, MADISONVILLE, TX 77864-2432
(936) 349-1574
Mailing address
114 E CRESCENT DR APT 1, MADISONVILLE, TX 77864-3076
(936) 436-3238

Taxonomy

Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
25560204
IL

Other

Enumeration date
10/28/2024
Last updated
05/15/2025
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