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Individual

CIDIA TREVINO GONZALEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
614 MACO DR, HARLINGEN, TX 78550-8450
(956) 296-7000
(956) 440-9801
Mailing address
PO BOX 531968, HARLINGEN, TX 78553-1968

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13166
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
405022101
TX
01
H08LX10101
BCBS
TX
Enumeration date
08/06/2019
Last updated
05/03/2024
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