Provider Demographics
NPI:1548388820
Name:TREVINO, JAMES GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GREGORY
Last Name:TREVINO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8038 WURZBACH RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3817
Mailing Address - Country:US
Mailing Address - Phone:210-615-8303
Mailing Address - Fax:210-614-2223
Practice Address - Street 1:8038 WURZBACH RD
Practice Address - Street 2:SUITE 250
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3817
Practice Address - Country:US
Practice Address - Phone:210-615-8303
Practice Address - Fax:210-614-2223
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2010-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ7292207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105318303Medicaid
TXG13750Medicare UPIN
TX00499LMedicare PIN