Individual
TREVOR DANE ANNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 220-7593
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 292-6255
(210) 292-7934
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101273965
VA
208D00000X
General Practice Physician
0101273965
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/16/2020
Last updated
08/21/2024
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