Crudup, Travis Wolfe
Crudup, Travis Wolfe is an sole proprietor health care provider with primary practice located at 1000 9Th Ave , Fort Worth TX 76104-3906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Crudup, Travis Wolfe can be contacted via phone (817) 927-2329.Contact Information
Primary practice address
1000 9Th Ave
Fort Worth TX 76104-3906
Phone: (817) 927-2329
Fax: (817) 924-0177
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | M6089 | Texas |
Profile Details
| NPI number | 1275741464 |
|---|---|
| LBN Legal business name | Crudup, Travis Wolfe |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 19th, 2007 |
| Last updated | Nov 4th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275741464 | NPPES |
| Texas | MEDICAID | 186315101 | |
| Texas | Other | P00440259 |
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