Doctor Name: | JUAN JESUS TREVINO |
NPI Number: | 1104122126 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | R.D. |
License Number: | 00874957 |
Business Practice Address: | 3640 Pencil Stick Dr Rio Grande City, TX - 785829301 |
Business Phone Number: | 9567350105 |
Business Fax Number: | 9564862720 |
Mailing Address: | 3640 Pencil Stick Dr, RIO GRANDE CITY |
State: | TX |
Postal Code: | 785829301 |
Phone Number: | 9567350105 |
Fax Number: | 9564862720 |
NPI Enumeration Date: | 02/09/2011 |
NPI Last Update Date: | 02/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 00874957 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |