MEDICARE: TRAVIS BLAKE JOHNS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1216101	TX

General Provider Information

NPI Number	:	1275400228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS BLAKE JOHNS NP

Provider Business Mailing Address
First Line	:	2701 US HIGHWAY 271 N
Second Line	:
City	:	PITTSBURG
State	:	TX
Zip	:	75686-4289
Country	:	US
Telephone Number	:	903-946-5442
Fax Number	:	903-946-5258

Provider Business Practice Location Address
First Line	:	2701 US HIGHWAY 271 N
Second Line	:
City	:	PITTSBURG
State	:	TX
Zip	:	75686-4289
Country	:	US
Telephone Number	:	903-946-5442
Fax Number	:	903-946-5358

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2025
Last Update Date	:	02/11/2026

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