Michelle J Trevino

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0012763 Issued in TX

Legal business name

MICHELLE J TREVINO

Practice address

2207 N Raul Longoria Rd
San Juan, TX 78589-4114

Phone

(956) 783-8875

Fax

(956) 783-3072

NPI assigned

May 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Joe Alvarez

Title

Director

Phone

(956) 783-8875

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1245281930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 RAUL LONGORIA ST",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785894114",
            "telephone_number": "956-783-8875",
            "fax_number": "956-783-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 N RAUL LONGORIA RD",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785894114",
            "telephone_number": "956-783-8875",
            "fax_number": "956-783-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE J TREVINO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "956-783-8875",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0012763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174157101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174157102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in San Juan, TX
• Providers in San Juan, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.