Provider Demographics
NPI:1346429834
Name:TREVINO, EDITH C (FNP)
Entity Type:Individual
Prefix:MS
First Name:EDITH
Middle Name:C
Last Name:TREVINO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:EDITH
Other - Middle Name:
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:110 N D SALINAS AVE
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-2926
Mailing Address - Country:US
Mailing Address - Phone:956-377-5545
Mailing Address - Fax:956-377-5547
Practice Address - Street 1:110 N D SALINAS AVE
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-2926
Practice Address - Country:US
Practice Address - Phone:956-377-5545
Practice Address - Fax:956-377-5547
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX622781363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX216074901Medicaid
TXTXB107680Medicare PIN