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Organization

MICHELLE J TREVINO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOE ALVAREZ (DIRECTOR)
(956) 783-8875
Entity
Organization

Contact information

Practice address
2207 N RAUL LONGORIA RD, SAN JUAN, TX 78589-4114
(956) 783-8875
(956) 783-3072
Mailing address
2207 RAUL LONGORIA ST, SAN JUAN, TX 78589-4114
(956) 783-8875
(956) 783-3072

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0012763
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
174157101
TX
05
174157102
TX
Enumeration date
05/15/2006
Last updated
06/25/2008
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  • EDI platform