Provider Demographics
NPI:1750312138
Name:TREVINO-BEENE, ELIZA (MD)
Entity Type:Individual
Prefix:
First Name:ELIZA
Middle Name:
Last Name:TREVINO-BEENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20523 BOBIGIAN DR
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-7207
Mailing Address - Country:US
Mailing Address - Phone:832-233-6587
Mailing Address - Fax:713-518-1108
Practice Address - Street 1:800 PEAKWOOD DR STE 6F
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2903
Practice Address - Country:US
Practice Address - Phone:281-444-1600
Practice Address - Fax:713-518-1108
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6682208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI31052Medicare UPIN