Provider Demographics
NPI:1376723833
Name:TRAVIS W. HIRD, M.D. PA
Entity Type:Organization
Organization Name:TRAVIS W. HIRD, M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HIRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-368-4232
Mailing Address - Street 1:P.O. BOX 9763
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77387-6763
Mailing Address - Country:US
Mailing Address - Phone:832-368-4232
Mailing Address - Fax:866-936-4875
Practice Address - Street 1:117 VISION PARK BLVD
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3001
Practice Address - Country:US
Practice Address - Phone:936-443-8460
Practice Address - Fax:866-936-4875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL57672081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160313601Medicaid
TX160316901Medicaid
TX8A8491Medicare PIN
TXH87381Medicare UPIN
TX160316901Medicaid