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NPI Code Detail

MEDICARE: TRAVIS JOSEPH GAU PHARMD

MEDICARE:   TRAVIS JOSEPH GAU  PHARMD
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
1183500000XPharmacist121019MN

General Provider Information

NPI Number : 1578810156
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRAVIS JOSEPH GAU PHARMD
Provider Business Mailing Address
First Line : 3620 TEXAS AVE S
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55426-4057
Country : US
Telephone Number : 952-933-3177
Fax Number :
Provider Business Practice Location Address
First Line : 3620 TEXAS AVE S
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55426-4057
Country : US
Telephone Number : 952-933-3177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2012
Last Update Date : 08/13/2012

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Directions to “ TRAVIS JOSEPH GAU PHARMD” Practice Location

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