Provider Demographics
NPI:1053887158
Name:TREVOR ROHM MD PA
Entity type:Organization
Organization Name:TREVOR ROHM MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-349-9124
Mailing Address - Street 1:221 RANGER ST
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79045-4113
Mailing Address - Country:US
Mailing Address - Phone:806-683-3131
Mailing Address - Fax:806-349-9379
Practice Address - Street 1:540 W 15TH ST
Practice Address - Street 2:
Practice Address - City:HEREFORD
Practice Address - State:TX
Practice Address - Zip Code:79045-2820
Practice Address - Country:US
Practice Address - Phone:806-364-2141
Practice Address - Fax:806-349-5652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty