Provider Demographics
NPI:1760718811
Name:TREVINO, KARINA LYNN (PA)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:LYNN
Last Name:TREVINO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 BUSINESS PARK DR STE 6
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6054
Mailing Address - Country:US
Mailing Address - Phone:956-519-0770
Mailing Address - Fax:
Practice Address - Street 1:909 BUSINESS PARK DR STE 6
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6054
Practice Address - Country:US
Practice Address - Phone:956-519-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06303363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA06303OtherTEXAS MEDICAL LICENSE