Individual
TRAVIS LEE WACHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC, PMHNP-BC
Contact information
Practice address
4659 FM 1990, PALESTINE, TX 75801-1162
(903) 213-2216
(903) 213-9233
Mailing address
4265 FM 1990, PALESTINE, TX 75801-1102
(903) 724-3913
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP131990
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP131990
TX
Other
Enumeration date
09/16/2016
Last updated
06/27/2023
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