Individual
DR. TRAVIS EDWARD WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D., CDE, BCPS
Contact information
Practice address
3625 NW 56TH ST, 5 CORPORATE PLAZA, OKLAHOMA CITY, OK 73112-4519
(405) 951-3829
(405) 951-3916
Mailing address
1200 OUTABOUNDS DR, EDMOND, OK 73034-3079
(405) 285-8766
(405) 951-3916
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
11493
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11493
PHARMACY LISCENSE
OK
01
—
20510562
CDE
—
01
—
3024935
BCPS CREDENTIAL
—
Enumeration date
05/24/2005
Last updated
07/08/2007
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