Provider Demographics
NPI:1932352036
Name:TREVINO, LINDA GABRIELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:GABRIELA
Last Name:TREVINO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CARDINAL LN
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SANTOS DEGALLADO 3343
Practice Address - Street 2:
Practice Address - City:NUEVO LAREDO
Practice Address - State:TAMAULIPAS
Practice Address - Zip Code:88240
Practice Address - Country:MX
Practice Address - Phone:956-465-4295
Practice Address - Fax:956-523-8701
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ32915931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice