Provider Demographics
NPI:1871803262
Name:TREVINO, MONICA VILLARREAL (FNP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:VILLARREAL
Last Name:TREVINO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-6120
Mailing Address - Fax:
Practice Address - Street 1:3939 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2291
Practice Address - Country:US
Practice Address - Phone:210-450-6120
Practice Address - Fax:210-450-6161
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP119351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX344817703OtherCSHCN
TX344817702Medicaid
TX401935YK00Medicare UPIN