Provider Demographics
NPI:1437166501
Name:HALL, TRAVIS B (DC)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:B
Last Name:HALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573
Mailing Address - Country:US
Mailing Address - Phone:281-332-3428
Mailing Address - Fax:281-332-7593
Practice Address - Street 1:1200 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:281-332-3428
Practice Address - Fax:281-332-7593
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9915111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
3798387OtherCIGNA
608088OtherBCBS
V03293Medicare UPIN
TX611360Medicare ID - Type Unspecified