Organization
JAVIER TREVINO
Active
Other names
Liberty Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAVIER TREVINO SR. RRT (OWNER)
(956) 631-7406
Entity
Organization
Contact information
Practice address
1349 E HACKBERRY AVE, MCALLEN, TX 78501-5702
(956) 631-7406
(956) 631-7506
Mailing address
1349 E HACKBERRY AVE, MCALLEN, TX 78501-5702
(956) 631-7406
(956) 631-7506
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
58015
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188084101
—
TX
05
—
188084102
—
TX
Enumeration date
10/25/2006
Last updated
07/10/2008
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