Provider Demographics
NPI:1275891160
Name:TREVINO, CHLOE ELISA (CSA)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:ELISA
Last Name:TREVINO
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 LONG DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4923
Mailing Address - Country:US
Mailing Address - Phone:832-367-8773
Mailing Address - Fax:
Practice Address - Street 1:2009 LONG DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-4923
Practice Address - Country:US
Practice Address - Phone:832-367-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical