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Individual

TRAVIS CASILLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NNP-BC

Contact information

Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(844) 424-4537
Mailing address
2825 CHATSWOOD DR, ROANOKE, TX 76262-3473

Taxonomy

Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
833654
TX
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
AP141365
TX

Other

Enumeration date
03/29/2019
Last updated
04/13/2019
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