Individual provider Active NPI

Jaime Trevino, MD

  • Family Medicine Physician
  • Eagle Pass, TX
National Provider Identifier
1811926306
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H8872 Issued in TX
Practice address
3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852-5148
Phone
(830) 773-5321
Fax
(830) 872-2948
NPI assigned
Jun 30, 2006
Last updated
Mar 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X H8872 TX
Family Medicine Physician 207Q00000X H8872 TX Primary

Addresses

Primary practice location

3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852-5148

Mailing address

2314 Ruby Oaks
San Antonio, TX 78232-5600
Phone (210) 545-4687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070305000447 TX Practitioner - Emergency MedicinePractitioner - Family Practice 3274636667 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H8872TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Jun 16, 2011 Accepting new patients
Memorial Medical Center CurrentSince Mar 11, 2012 Accepting new patients
Memorial Medical Center CurrentSince Mar 11, 2012 Accepting new patients
Maverick Emergency Medicine Associates PA Emergency Medicine CurrentSince Mar 10, 2020 Accepting new patients
Comanche County Medical Center Company CurrentSince Sep 4, 2016 Accepting new patients
Comanche County Medical Center Company CurrentSince Sep 4, 2016 Accepting new patients
Memorial Medical Center Current Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Jun 16, 2011 Accepting new patients
Texas Emergency Room Services, PA Emergency Medicine Past Accepting new patients
Step Emergency Physicians Emergency Medicine Past Accepting new patients
Texas Emergency Room Services PA Emergency Medicine Past Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

10201 Highway 16
Comanche, TX 76442
Phone (254) 879-4910

3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852
Phone (830) 733-5321

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

3100 Avenue E
Hondo, TX 78861
Phone (830) 426-7700

200 S Interstate 35
Pearsall, TX 78061
Phone (888) 250-2326

815 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-0325

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1811926306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 RUBY OAKS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782325600",
            "telephone_number": "210-545-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N FOSTER MALDONADO BLVD",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788525148",
            "telephone_number": "830-773-5321",
            "fax_number": "830-872-2948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "JAIME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "H8872",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H8872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

Verify at the official NPI Registry.