Individual
DR. DIANE TREVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
177 THORAIN BLVD, SAN ANTONIO, TX 78212-1227
(210) 391-8457
Mailing address
177 THORAIN BLVD, SAN ANTONIO, TX 78212-1227
(210) 391-8457
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1622
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018574601
—
TX
01
—
P00398188
RAILROAD MEDICARE
TX
Enumeration date
02/01/2006
Last updated
05/02/2012
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