Provider Demographics
NPI:1649536392
Name:PITCHER, TREVOR
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:PITCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7019 LASKER DR
Mailing Address - Street 2:APT 1123
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-1788
Mailing Address - Country:US
Mailing Address - Phone:559-310-1421
Mailing Address - Fax:
Practice Address - Street 1:501 S FLOYD ST
Practice Address - Street 2:MDR BLDG, RM 208
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3805
Practice Address - Country:US
Practice Address - Phone:502-852-1772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program