Juan Trejo
Individual provider Active NPI Home Modifications Contractor · Clint, TX
NPI 1922455294 · NPPES record last updated May 17, 2016
Key facts
- NPI
- 1922455294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Modifications Contractor 171WH0202X
- License
- 09111246 (TX)
- Practice address
- 13909 Alameda Ave
Clint, TX 79836-6118 - Phone
- (915) 637-5193
- NPI assigned
- May 17, 2016
- Sex
- Male
- 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 |
|---|---|---|---|
| 09111246 | TX | MD | Home Modifications Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 09111246 | TX | Yes |
Addresses
Primary practice location
13909 Alameda Ave
Clint, TX 79836-6118
Mailing address
13909 Alameda Ave
Clint, TX 79836-6118
Phone (915) 637-5193
Other providers in Clint, TX
- Chukwujekwu Okpalaji
- Project Vida Health Center
- Project Vida Health Center
- R.J. Owen. PLLC
- Loretta Rivera
- Kamie Zavala
All providers in Clint, TX · Home Modifications Contractor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2016. 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.