Healthcare Provider Details

I. General information

NPI: 1376723833
Provider Name (Legal Business Name): TRAVIS W. HIRD, M.D. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2007
Last Update Date: 02/12/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 VISION PARK BLVD
SHENANDOAH TX
77384-3001
US

IV. Provider business mailing address

P.O. BOX 9763
SPRING TX
77387-6763
US

V. Phone/Fax

Practice location:
  • Phone: 936-443-8460
  • Fax: 866-936-4875
Mailing address:
  • Phone: 832-368-4232
  • Fax: 866-936-4875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberL5767
License Number StateTX

VIII. Authorized Official

Name: DR. TRAVIS WILLIAM HIRD
Title or Position: OWNER/PROVIDER
Credential: M.D.
Phone: 832-368-4232