Provider Demographics
NPI:1003864943
Name:TRAVIS, JO ANN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JO ANN
Middle Name:F
Last Name:TRAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 CLIFFBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-8003
Mailing Address - Country:US
Mailing Address - Phone:972-239-2896
Mailing Address - Fax:469-327-9314
Practice Address - Street 1:3500 GASTON AVE
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2096
Practice Address - Country:US
Practice Address - Phone:214-549-4835
Practice Address - Fax:469-327-9314
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7757207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00EK21Medicare ID - Type Unspecified
C22826Medicare UPIN