Basic Information
Provider Information
NPI: 1841835907
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRIGG
FirstName: CORA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 419 CARSON HL STE 202
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782515500
CountryCode: US
TelephoneNumber: 2106341129
FaxNumber:  
Practice Location
Address1: 419 CARSON HL STE 202
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782515500
CountryCode: US
TelephoneNumber: 2106341129
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/13/2019
LastUpdateDate: 10/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106S00000X  N    
106S00000XRBT-20-113993NMY    

No ID Information.


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