Provider Demographics
NPI:1780666024
Name:HANSON, TRAVIS W (MD)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:W
Last Name:HANSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18220 STATE HIGHWAY 249
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4347
Mailing Address - Country:US
Mailing Address - Phone:281-737-0999
Mailing Address - Fax:281-737-0926
Practice Address - Street 1:18220 STATE HIGHWAY 249
Practice Address - Street 2:SUITE 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:281-737-0999
Practice Address - Fax:281-737-0926
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL4423207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610197302 FANNINOtherUS DEPT OF LABOR
TX8DY868OtherBLUE CROSS BLUE SHIELD
601771109OtherUS DEPT OF LABOR
616771105OtherUS DEPT OF LABOR
TXP00931461OtherMEDICARE RR
TXP01258265OtherMEDICARE RR
TX163086502Medicaid
TX163086503Medicaid
616771101OtherUS DEPT OF LABOR
616771110OtherUS DEPT OF LABOR
TXP01055683OtherRR MEDICARE
TX1780666024OtherBLUE CROSS BLUE SHIELD
TX610197301 CENTERFIELOtherUS DEPT OF LABOR
616771105OtherUS DEPT OF LABOR
TXP00931461OtherMEDICARE RR
601771109OtherUS DEPT OF LABOR