Individual provider Active NPI

Alfredo Trejo Jr., OD

  • Optometrist
  • Edinburg, TX
National Provider Identifier
1932620382
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9214T Issued in TX
Practice address
2518 W Trenton Rd
Edinburg, TX 78539-8070
Phone
(956) 661-9000
Fax
(956) 661-9881
NPI assigned
Jul 6, 2017
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9214T TX Primary

Addresses

Primary practice location

2518 W Trenton Rd
Edinburg, TX 78539-8070

Mailing address

2518 W Trenton Rd
Edinburg, TX 78539-8070
Phone (956) 661-9000

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410002754 TX Practitioner - Optometry 8123394392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9214TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carlos Manrique de Lara Mdpa Optometrist CurrentSince Feb 26, 2024 Accepting new patients
Aeg Texas Professional PLLC Optometrist PastSince Feb 23, 2025 Accepting new patients
William Justus Head MD PA PastSince Feb 26, 2024 Accepting new patients

Locations

2518 W Trenton Rd
Edinburg, TX 78539
Phone (956) 661-9000

Organizations & group practices 3

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": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1932620382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 W TRENTON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398070",
            "telephone_number": "956-661-9000",
            "fax_number": "956-661-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 W TRENTON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398070",
            "telephone_number": "956-661-9000",
            "fax_number": "956-661-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREJO",
        "first_name": "ALFREDO",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-06",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9214T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.