Provider Demographics
NPI:1396006540
Name:TREVINO, NATALEE NICOLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATALEE
Middle Name:NICOLE
Last Name:TREVINO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6295 LOCKHILL RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2016
Mailing Address - Country:US
Mailing Address - Phone:210-326-2651
Mailing Address - Fax:
Practice Address - Street 1:9815 CULEBRA RD
Practice Address - Street 2:110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3702
Practice Address - Country:US
Practice Address - Phone:210-892-8557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX274911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice