Provider Demographics
NPI:1336189125
Name:TREJO, GINGER A (NP)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:A
Last Name:TREJO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17350 ST LUKES WAY STE 390
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4167
Mailing Address - Country:US
Mailing Address - Phone:936-273-1600
Mailing Address - Fax:936-273-1635
Practice Address - Street 1:17350 ST LUKES WAY STE 390
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4167
Practice Address - Country:US
Practice Address - Phone:936-273-1600
Practice Address - Fax:936-273-1635
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX598440363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180180502Medicaid
TX180180501Medicaid
TX279297YKYCMedicare PIN
TX8G4056Medicare PIN
TX180180502Medicaid