Individual
MR. MICHAEL TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6104 AVENUE Q SOUTH DR, LUBBOCK, TX 79412-3700
(806) 472-3430
(806) 472-3432
Mailing address
6104 AVENUE Q SOUTH DR, LUBBOCK, TX 79412-3700
(806) 472-3430
(806) 472-3432
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01707
TX
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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