| NPI | 1710232665 |
|---|---|
| Former Legal Business Name | LUIS M TREVINO |
| Entity Type | Organization |
| Authorized Contact | LUIS MIGUEL TREVINO President/Orthodontist 956-523-8701 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: ZZ 3395326) |
| Additional Taxonomies | 122300000X Dentist (Licence: ZZ 3291593) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ZZ 3395326) | |
| 305R00000X Preferred Provider Organization (Licence: ZZ 3395326) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |