Provider Demographics
NPI:1588612865
Name:TRAYNHAM, JULIE A (DO)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:TRAYNHAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15080 FM 156 STE D
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-7923
Mailing Address - Country:US
Mailing Address - Phone:940-242-0300
Mailing Address - Fax:940-242-0278
Practice Address - Street 1:15080 FM 156 STE D
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247-7923
Practice Address - Country:US
Practice Address - Phone:940-242-0300
Practice Address - Fax:940-242-0278
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6244207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M9070OtherBCBS
TX163106101Medicaid
TX8B3606Medicare PIN
TX163106101Medicaid