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General NPI Number Information
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NPI Number | 1477726263
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Entity Type | Organization
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Legal Business Name | WM RICHARD TRAVIS, MD, PA
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 04/11/2008
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Provider Practice Location Address
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Address Line | 175 RIDGE RD STE# 800
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City | MCKINNEY
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State | TX
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Zip | 75070-5102
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Country | US
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Telephone | 972-562-1018
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Fax | 972-562-1026
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Provider Business Mailing Address
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Address Line | 175 RIDGE RD STE# 800
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City | MCKINNEY
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State | TX
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Zip | 75070-5102
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Country | US
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Telephone | 972-562-1018
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Fax | 972-562-1026
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | WILLIAM RICHARD TRAVIS
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Credential | MD
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Telephone | 469-667-9449
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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 | H8954
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License Number State | TX
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