Wies, Travis J

Wies, Travis J is an individual health care provider with primary practice located at 1339 S Broadway St , Sulphur Springs TX 75482. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Wies, Travis J can be contacted via phone (903) 951-1001.

Contact Information

Primary practice address
1339 S Broadway St Sulphur Springs TX 75482
Phone: (903) 951-1001
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP132187 Texas

Profile Details

NPI number 1952607467
LBN Legal business name Wies, Travis J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2011
Last updated Oct 28th, 2019 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952607467 NPPES
Texas Other 787723 MEDICARE
Texas Other P02223412 MEDICARE
Texas MEDICAID 363776103 MEDICARE

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