Individual ProviderYadira Enid TrevinoSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1611 Headway Cir Bldg 2, Austin, TX 78754-5165(512) 615-6839(617) 501-7207PECOS EnrollmentBased on the most recent information from CMS, provider Yadira Enid Trevino does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1891926465Provider TypeIndividualFull NameTrevino, Yadira EnidTitleMs.CredentialM.S., SLPGenderFemaleSole ProprietorNoEnumeration Date7/30/2009Last Updated7/30/2009Contact InformationPractice LocationPractice Address1611 Headway Cir Bldg 2, Austin, TX 78754-5165Phone(512) 615-6839FaxUnlisted FaxMailing LocationMailing Address12800 Center Lake Dr, #315, Austin, TX 78753-1082Phone(617) 501-7207FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense104619TexasProvider IdentifiersIDDescriptionIssuerID021286201DescriptionMedicaidIssuerUnlistedTexas