Provider Demographics
NPI:1841740552
Name:TRAXX FEDERATED, LLC
Entity Type:Organization
Organization Name:TRAXX FEDERATED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-939-1934
Mailing Address - Street 1:PO BOX 744
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78767-0744
Mailing Address - Country:US
Mailing Address - Phone:415-939-1934
Mailing Address - Fax:877-409-5701
Practice Address - Street 1:800 W 5TH ST
Practice Address - Street 2:UNIT 1008
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-5434
Practice Address - Country:US
Practice Address - Phone:415-939-1934
Practice Address - Fax:877-409-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty