Provider Demographics
NPI:1477988970
Name:TREVINO ORTHOPAEDICS PLLC
Entity Type:Organization
Organization Name:TREVINO ORTHOPAEDICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:210-657-5600
Mailing Address - Street 1:PO BOX 171285
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-8285
Mailing Address - Country:US
Mailing Address - Phone:210-657-5600
Mailing Address - Fax:210-657-5601
Practice Address - Street 1:8601 VILLAGE DR
Practice Address - Street 2:STE 206
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5512
Practice Address - Country:US
Practice Address - Phone:210-657-5600
Practice Address - Fax:210-657-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7012207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty