Provider Demographics
NPI:1093006371
Name:TRAVIS MEDICAL SALES CORPORATION
Entity Type:Organization
Organization Name:TRAVIS MEDICAL SALES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-458-4589
Mailing Address - Street 1:1104 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1908
Mailing Address - Country:US
Mailing Address - Phone:512-458-4589
Mailing Address - Fax:512-454-9521
Practice Address - Street 1:10421 GULFDALE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4130
Practice Address - Country:US
Practice Address - Phone:210-366-1215
Practice Address - Fax:210-366-1236
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRAVIS MEDICAL SALES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-21
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies