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General NPI Number Information
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NPI Number | 1255931614
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Entity Type | Individual
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Provider Name | TRAVIS ALLISON PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 720 W PIPELINE RD
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City | HURST
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State | TX
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Zip | 76053-4928
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Country | US
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Telephone | 817-799-3525
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Fax |
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Provider Business Mailing Address
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Address Line | 4217 SWISS AVE APT 353
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City | DALLAS
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State | TX
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Zip | 75204-6685
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Country | US
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Telephone | 806-654-7441
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 62666
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License Number State | TX
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