Provider Demographics
NPI:1700143492
Name:TREVINO, SHEILA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:
Last Name:TREVINO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 W MILE 17 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-2057
Mailing Address - Country:US
Mailing Address - Phone:956-207-9121
Mailing Address - Fax:956-292-0572
Practice Address - Street 1:4107 W MILE 17 1/2 RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-2057
Practice Address - Country:US
Practice Address - Phone:956-207-9121
Practice Address - Fax:956-292-0572
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor