Provider Demographics
NPI:1124540851
Name:TREVINO, PERLA (NP)
Entity Type:Individual
Prefix:
First Name:PERLA
Middle Name:
Last Name:TREVINO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PERLA
Other - Middle Name:
Other - Last Name:TREVINO CASTILLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:4101 S STAPLES ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5501
Mailing Address - Country:US
Mailing Address - Phone:361-883-8001
Mailing Address - Fax:361-814-0000
Practice Address - Street 1:4101 S STAPLES ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5501
Practice Address - Country:US
Practice Address - Phone:361-883-8001
Practice Address - Fax:361-814-0000
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134905363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily