Individual
DR. EDWIN JAY TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC CCSP CVCP ACN
Contact information
Practice address
45 LOOP 150 W, BASTROP, TX 78602-3930
(512) 321-4481
(512) 321-9737
Mailing address
45 LOOP 150 W, BASTROP, TX 78602-3930
(512) 321-4481
(512) 321-9737
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4037
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1226201
—
TX
01
—
350055841
RAILROAD MEDICARE
TX
Enumeration date
01/09/2007
Last updated
05/15/2019
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