Provider Demographics
NPI:1376720730
Name:WHITNEY, MARIA TERESA TREVINO (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA TREVINO
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4114 POND HILL RD
Mailing Address - Street 2:STE 202
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1273
Mailing Address - Country:US
Mailing Address - Phone:210-200-8805
Mailing Address - Fax:210-200-8543
Practice Address - Street 1:4114 POND HILL RD
Practice Address - Street 2:STE 202
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1273
Practice Address - Country:US
Practice Address - Phone:210-200-8805
Practice Address - Fax:210-200-8543
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN1493207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204402603Medicaid
TX323018YSNRMedicare PIN