MEDICARE: DR. TRAVIS W HIRD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	L5767	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265424980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRAVIS W HIRD M.D.

Provider Business Mailing Address
First Line	:	PO BOX 9763
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77387-6763
Country	:	US
Telephone Number	:	832-368-4232
Fax Number	:	866-936-4875

Provider Business Practice Location Address
First Line	:	117 VISION PARK BLVD
Second Line	:
City	:	SHENANDOAH
State	:	TX
Zip	:	77384-3001
Country	:	US
Telephone Number	:	936-443-8460
Fax Number	:	866-836-4875

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	01/23/2024

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