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General NPI Number Information
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NPI Number | 1144648684
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Entity Type | Individual
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Provider Name | TRAVIS GRATTON
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Gender | Male
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1180 SETON PKWY STE 450
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City | KYLE
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State | TX
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Zip | 78640-6178
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Country | US
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Telephone | 512-504-0860
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 W 32ND ST STE 300
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City | AUSTIN
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State | TX
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Zip | 78705-1917
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Country | US
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Telephone | 512-324-1000
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Fax | 512-406-6513
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 8138
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | T1711
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License Number State | TX
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