Provider Demographics
NPI:1386224822
Name:DAVID LEE TREVINO DDS PA
Entity Type:Organization
Organization Name:DAVID LEE TREVINO DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-534-3220
Mailing Address - Street 1:302 N TEXAS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-2732
Mailing Address - Country:US
Mailing Address - Phone:956-825-9090
Mailing Address - Fax:956-825-9191
Practice Address - Street 1:302 N TEXAS AVE STE A
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-2732
Practice Address - Country:US
Practice Address - Phone:956-825-9090
Practice Address - Fax:956-825-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty