Healthcare Provider Details

I. General information

NPI: 1770713646
Provider Name (Legal Business Name): TRAVIS SARGENT DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2009
Last Update Date: 07/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N PECOS RD SUITE 200
HENDERSON NV
89074-1347
US

IV. Provider business mailing address

321 N PECOS RD SUITE 200
HENDERSON NV
89074-1347
US

V. Phone/Fax

Practice location:
  • Phone: 702-263-4925
  • Fax:
Mailing address:
  • Phone: 702-263-4925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01276
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberB01276
License Number StateNV

VIII. Authorized Official

Name: DR. TRAVIS NORMAN SARGENT
Title or Position: PRESIDENT
Credential: D.C.
Phone: 702-263-4925