Provider Demographics
NPI:1275061277
Name:TREVINO, ALEXANDRA HANSON
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:HANSON
Last Name:TREVINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 SOUTH LOOP E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-1626
Mailing Address - Country:US
Mailing Address - Phone:713-967-9803
Mailing Address - Fax:
Practice Address - Street 1:4455 CULLEN BLVD RM 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77204-6018
Practice Address - Country:US
Practice Address - Phone:713-743-0915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist