Individual
TRAVIS M WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4321 KINGWOOD DR, SUITE 177, KINGWOOD, TX 77339-3700
(281) 883-6748
Mailing address
4321 KINGWOOD DR, SUITE 177, KINGWOOD, TX 77339-3700
(281) 883-6748
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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