Healthcare Provider Details

I. General information

NPI: 1912862665
Provider Name (Legal Business Name): TRAVIS SCHOCHLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 E METHVIN ST
LONGVIEW TX
75601-6519
US

IV. Provider business mailing address

2830 COVINGTON CIR
SHREVEPORT LA
71106-8294
US

V. Phone/Fax

Practice location:
  • Phone: 903-212-7788
  • Fax:
Mailing address:
  • Phone: 903-220-9932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1218794
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: