Provider Demographics
NPI:1780723791
Name:ROHM, TREVOR (MD)
Entity type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:
Last Name:ROHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79045-2820
Mailing Address - Country:US
Mailing Address - Phone:806-364-7512
Mailing Address - Fax:806-364-5256
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
Practice Address - Country:US
Practice Address - Phone:806-364-7512
Practice Address - Fax:806-364-5256
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4505207P00000X, 208M00000X, 207Q00000X
NMMD2007-0488207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX312101401Medicaid