| Dr Chris T Trevino, MD | |
|
41229 Highway 941, Gonzales, LA 70737-8206 | |
| (225) 806-3397 | |
| (225) 644-1423 |
| Full Name | Dr Chris T Trevino |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 41229 Highway 941, Gonzales, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386650745 | NPI | - | NPPES |
| 5A536 | Other | LA | MEDICARE PTAN |
| 1698270 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 023255 (Louisiana) | Secondary |
| 207P00000X | Emergency Medicine | 023255 (Louisiana) | Primary |
| Entity Name | C & M Medical Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710903059 PECOS PAC ID: 9436061553 Enrollment ID: O20050121000093 |
| Entity Name | Our Lady Of The Lake Physician Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 |
| Entity Name | Ascension Emergency Physicians, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699118505 PECOS PAC ID: 9739320029 Enrollment ID: O20130730000082 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Chris T Trevino, MD 41229 Highway 941, Gonzales, LA 70737-8206 Ph: (225) 806-3397 | Dr Chris T Trevino, MD 41229 Highway 941, Gonzales, LA 70737-8206 Ph: (225) 806-3397 |
Paul B Trisler, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1125 W Highway 30, Gonzales, LA 70737 Phone: 817-451-4208 |