Provider Demographics
NPI:1447353222
Name:BIVENS, TRINA (MD)
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:BIVENS
Suffix:
Gender:F
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:COLLIN COUNTY DETENTION CENTER
Mailing Address - Street 2:4300 COMMUNITY AVENUE
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071
Mailing Address - Country:US
Mailing Address - Phone:972-547-7260
Mailing Address - Fax:972-547-5390
Practice Address - Street 1:COLLIN COUNTY DETENTION CENTER
Practice Address - Street 2:4300 COMMUNITY AVENUE
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071
Practice Address - Country:US
Practice Address - Phone:972-547-7260
Practice Address - Fax:972-547-5390
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK35572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8E0526Medicare ID - Type Unspecified
TX00737YMedicare ID - Type Unspecified
H56662Medicare UPIN