Provider Demographics
NPI:1104892447
Name:TREVINO, SONIA MELISSA (DC)
Entity type:Individual
Prefix:DR
First Name:SONIA
Middle Name:MELISSA
Last Name:TREVINO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2939
Mailing Address - Country:US
Mailing Address - Phone:956-519-3111
Mailing Address - Fax:956-519-3324
Practice Address - Street 1:700 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2939
Practice Address - Country:US
Practice Address - Phone:956-519-3111
Practice Address - Fax:956-519-3324
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor