# TRAVIS MEDICAL SALES CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598136699
- **Authorized official:** JEFFREY MATUKEWICZ (SECRETARY)
- **Authorized official phone:** (423) 756-2268

## Contact information

- **Practice address:** 604 N NOLAN RIVER RD, CLEBURNE, TX 76033-7008
- **Practice address phone:** (817) 645-4718
- **Practice address fax:** (817) 641-2960
- **Mailing address:** 5959 SHALLOWFORD RD STE 443, CHATTANOOGA, TN 37421-2245
- **Mailing address phone:** (423) 756-2268
- **Mailing address fax:** (423) 362-5413

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |

## Other

- **Enumeration date:** 10/14/2015
- **Last updated:** 03/25/2021