Provider Demographics
NPI:1457133738
Name:DOLLING, TREVOR M (PA)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:M
Last Name:DOLLING
Suffix:
Gender:M
Credentials:PA
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3827 N 10TH ST STE 305
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1745
Mailing Address - Country:US
Mailing Address - Phone:956-803-0748
Mailing Address - Fax:
Practice Address - Street 1:296 COTTAGE AVE
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-4942
Practice Address - Country:US
Practice Address - Phone:209-624-7006
Practice Address - Fax:209-554-4601
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA63889363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant