Provider Demographics
NPI:1689323461
Name:HYATT, TRAVIS NELSON (DO)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:NELSON
Last Name:HYATT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36010 E PARK DR
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:TX
Mailing Address - Zip Code:77445-7953
Mailing Address - Country:US
Mailing Address - Phone:713-906-6637
Mailing Address - Fax:
Practice Address - Street 1:6431 FANNIN ST STE JJL 308S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-7616
Practice Address - Fax:713-500-7606
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program