Active NPI
Trevor Alexander Dickey, MD
- Pediatrics Physician
- San Antonio, TX
National Provider Identifier
1780374652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R80188
- Practice address
- 4502 Medical Dr
San Antonio, TX 78229-4402 - Phone
- (210) 358-4000
- NPI assigned
- May 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R80188 | AZ | Primary |
Addresses
Primary practice location
4502 Medical Dr
San Antonio, TX 78229-4402
Mailing address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230628000168 | AZ | Order and Referring Only - Pediatric Medicine | 4789042417 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R80188 | AZ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780704000000",
"number": "1780374652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-358-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-358-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKEY",
"first_name": "TREVOR",
"middle_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-12",
"last_updated": "2026-06-06",
"certification_date": "2026-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "R80188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.