Organization
TRAVIS OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED MATTHEW TRAVIS OPTICIAN (OWNER)
(919) 477-4006
Entity
Organization
Contact information
Practice address
3901 N ROXBORO RD, DURHAM, NC 27704-0118
(919) 477-4006
(919) 477-4006
Mailing address
PO BOX 15118, DURHAM, NC 27704-0118
(919) 477-4006
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
341
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8801919
—
NC
Enumeration date
12/27/2006
Last updated
08/22/2020
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