Healthcare Provider Details

I. General information

NPI: 1184088908
Provider Name (Legal Business Name): TRAVIS VOWELS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MEDICAL DR
AMARILLO TX
79106-4136
US

IV. Provider business mailing address

PO BOX 840026
DALLAS TX
75284-0026
US

V. Phone/Fax

Practice location:
  • Phone: 806-212-6604
  • Fax: 806-212-0355
Mailing address:
  • Phone: 806-358-0285
  • Fax: 806-356-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberBP10056957
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberT3408
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: