Provider Demographics
NPI:1801028154
Name:TOUPS, TRAVIS PAUL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:PAUL
Last Name:TOUPS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY
Mailing Address - Street 2:STE 300
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:13554 HIGHWAY 3235
Practice Address - Street 2:STE B
Practice Address - City:LAROSE
Practice Address - State:LA
Practice Address - Zip Code:70373
Practice Address - Country:US
Practice Address - Phone:985-693-7999
Practice Address - Fax:985-693-6449
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07566225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
766396OtherOPTUM
LA314918YUZ5OtherMEDICARE PTAN
LA314918YWWBOtherMEDICARE PTAN