Michelle Lynn Trevino
Individual provider Active NPI Physical Therapy Assistant · Goliad, TX
NPI 1295218980 · NPPES record last updated Sep 10, 2018
Key facts
- NPI
- 1295218980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2106029 (TX)
- Practice address
- 225 E Ward St
Goliad, TX 77963-4006 - Phone
- (361) 645-8902
- NPI assigned
- Sep 10, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2106029 | TX | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant |
225200000X | 2106029 | TX | Yes |
Addresses
Primary practice location
225 E Ward St
Goliad, TX 77963-4006
Mailing address
225 E Ward St
Goliad, TX 77963-4006
Other providers in Goliad, TX
- Jose Luis Ortiz
- Dylan Fanelli Riedesel
- Sahara Medical Consulting, PLLC
- Jacqueline Denean Stehling
- Gilbert G Tamez
- Lorie Anne Vernor
- Mary Wade
- Laura Lynn Wells
All providers in Goliad, TX · Physical Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.