Thadeo Gonzales Trivilegio, ASCPI,CM

Primary specialty

Medical Laboratory TechnicianTaxonomy code 246RM2200X

License

25560204 Issued in IL

Practice address

100 W Cross St
Madisonville, TX 77864-2432

Phone

(936) 349-1574

NPI assigned

Oct 28, 2024

Last updated

Aug 12, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1033931589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E CRESCENT DR APT 1",
            "city": "MADISONVILLE",
            "state": "TX",
            "postal_code": "778643076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CROSS ST",
            "city": "MADISONVILLE",
            "state": "TX",
            "postal_code": "778642432",
            "telephone_number": "936-349-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVILEGIO",
        "first_name": "THADEO",
        "middle_name": "GONZALES",
        "name_prefix": "Mr.",
        "credential": "ASCPI,CM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-28",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "IL",
            "license": "25560204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ten Broeck Tennessee Physicians (CHI St. Joseph Health Madison Hospital d/b/a Senior Renewal Center)
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• Traditions Health Care of Madisonville, LLC (Traditions Health)
• Trusted Hearts Health Services, PLLC (Aurora Concepts Madisonville)
• Maria Antonia Vera
• Bobby Melvin Vincent, MD
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0446)
• Walker County Hospital Corporation (Huntsville Memorial Hospital)

• Medical Laboratory Technician in Madisonville, TX
• Providers in Madisonville, TX by specialty
• Medical Laboratory Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.