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Individual

TRAVIS H BIRD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5670 WYNN RD STE D, LAS VEGAS, NV 89118-2355
(702) 776-4114
(701) 909-3757
Mailing address
5670 WYNN RD STE D, LAS VEGAS, NV 89118-2355
(702) 776-4114
(701) 909-3757

Taxonomy

Speciality
Code
Description
License number
State
331L00000X
Blood Bank
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
82-1780632
IRS
OH
Enumeration date
08/10/2017
Last updated
07/21/2022
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