Provider Demographics
NPI:1003295320
Name:DURDIN, TREY DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:TREY
Middle Name:DENNIS
Last Name:DURDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 PINE ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2450
Mailing Address - Country:US
Mailing Address - Phone:325-670-6180
Mailing Address - Fax:833-437-1278
Practice Address - Street 1:1904 PINE ST STE 3A
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2450
Practice Address - Country:US
Practice Address - Phone:325-670-6180
Practice Address - Fax:833-437-1278
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX594025208600000X
NY301446-01208800000X
TXR7717208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX594025OtherPHYSICIAN IN TRAINING