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Individual
TRAVIS SCOTT WALL
Active
Individual
TRAVIS SCOTT WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3105478-1205
UT
207RC0000X
Cardiovascular Disease Physician
3105478-1205
UT
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
3105478-1205
UT
Other
Enumeration date
10/18/2006
Last updated
08/08/2023
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