Provider Demographics
NPI:1962943134
Name:TREVINO, CASSANDRA M (PA-C)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:M
Last Name:TREVINO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 SHORT LINE ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-7375
Mailing Address - Country:US
Mailing Address - Phone:956-457-2872
Mailing Address - Fax:
Practice Address - Street 1:1010 JAMES ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6654
Practice Address - Country:US
Practice Address - Phone:956-968-1621
Practice Address - Fax:956-447-0646
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical