Provider Demographics
NPI:1174662696
Name:ARTHUR, THERESA TREVINO (PA-C)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:TREVINO
Last Name:ARTHUR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:DENISE
Other - Last Name:TREVINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1602 E HOUSTON ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-5326
Mailing Address - Country:US
Mailing Address - Phone:361-358-9200
Mailing Address - Fax:361-362-1717
Practice Address - Street 1:1602 E HOUSTON ST
Practice Address - Street 2:SUITE C
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-5326
Practice Address - Country:US
Practice Address - Phone:361-358-9200
Practice Address - Fax:361-362-1717
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01807363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical