Provider Demographics
NPI:1992215792
Name:HARNEY, TRAVIS CHAD (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:CHAD
Last Name:HARNEY
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 UNIVERSITY AVE
Mailing Address - Street 2:STE C
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4432
Mailing Address - Country:US
Mailing Address - Phone:806-712-1096
Mailing Address - Fax:806-771-2093
Practice Address - Street 1:1619 COMMON ST STE 203
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3454
Practice Address - Country:US
Practice Address - Phone:210-701-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135346363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner