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NPI Code Detail

MEDICARE: DR. KATE JORDAN TRAVIS MD

MEDICARE: DR. KATE JORDAN TRAVIS MD
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
12084P0800XPsychiatry PhysicianU2655TX

General Provider Information

NPI Number : 1396205183
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATE JORDAN TRAVIS MD
Provider Business Mailing Address
First Line : 6550 FANNIN ST STE 2509
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2777
Country : US
Telephone Number : 346-238-2040
Fax Number : 713-383-9026
Provider Business Practice Location Address
First Line : 6550 FANNIN ST STE 2509
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2777
Country : US
Telephone Number : 346-238-2040
Fax Number : 713-383-9026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2019
Last Update Date : 11/06/2023

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