Provider Demographics
NPI:1194250092
Name:TRIVETTE, GEORGE ALEXANDER JR (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:ALEXANDER
Last Name:TRIVETTE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 PAPPAS ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-1705
Mailing Address - Country:US
Mailing Address - Phone:956-795-8100
Mailing Address - Fax:
Practice Address - Street 1:7109 N BARTLETT AVE STE 101
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6473
Practice Address - Country:US
Practice Address - Phone:956-717-5775
Practice Address - Fax:956-717-5875
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT1246207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology