Provider Demographics
NPI:1912921990
Name:TRIGO, LUIS C III (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:C
Last Name:TRIGO
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 HEDGEROW DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5453
Mailing Address - Country:US
Mailing Address - Phone:972-566-8403
Mailing Address - Fax:
Practice Address - Street 1:4120 HEDGEROW DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5453
Practice Address - Country:US
Practice Address - Phone:972-566-8403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2467207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116165502Medicaid
TX116165505Medicaid
TX116165507Medicaid
TX116165509Medicaid
TX116165506Medicaid
TX116165508Medicaid
TX8C0778Medicare ID - Type UnspecifiedDALLAS COUNTY
TX116165506Medicaid
TX8D8115Medicare ID - Type UnspecifiedTARRANT
TX8574J8Medicare PIN
TX8L9501Medicare PIN
TX116165508Medicaid
TX116165509Medicaid