Provider Demographics
NPI:1437296258
Name:TREVINO, CYNTHIA FLETCHER (OD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:FLETCHER
Last Name:TREVINO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:FLETCHER
Other - Last Name:TREVINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:7959 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3430
Mailing Address - Country:US
Mailing Address - Phone:210-735-5440
Mailing Address - Fax:210-342-2039
Practice Address - Street 1:7959 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3430
Practice Address - Country:US
Practice Address - Phone:210-735-5440
Practice Address - Fax:210-342-2039
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4386152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist