| Kenneth Trevino, Ph.d., Pllc | |
|
12801 N Central Expy Ste 1730 Dallas TX 75243-1872 | |
| (817) 320-0704 | |
| (972) 677-7784 |
| Full Name | Kenneth Trevino, Ph.d., Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 12801 N Central Expy Ste 1730, Dallas, Texas |
| Authorized Official Name and Position | Kenneth Trevino (OWNER/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8173200704 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Trevino, Ph.d., Pllc 12801 N Central Expy Ste 1730 Dallas TX 75243-1872 Ph: (817) 320-0704 | Kenneth Trevino, Ph.d., Pllc 12801 N Central Expy Ste 1730 Dallas TX 75243-1872 Ph: (817) 320-0704 |
| NPI Number | 1588203111 |
|---|---|
| Provider Enumeration Date | 12/30/2019 |
| Last Update Date | 12/30/2019 |
| Certification Date | 12/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588203111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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