Individual
TRAVIS HOUSEHOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3150 N TENAYA WAY STE 260, LAS VEGAS, NV 89128-0459
(702) 962-5920
Mailing address
PO BOX 100744, ATLANTA, GA 30384-6666
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3037
NV
Other
Enumeration date
12/05/2014
Last updated
07/09/2024
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