Individual
TRAVIS KENNETH LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
9900 RICHMOND AVE APT 813, HOUSTON, TX 77042-4538
(314) 299-0229
Mailing address
9900 RICHMOND AVE APT 813, HOUSTON, TX 77042-4538
(314) 299-0229
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA0060011422
TX
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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