Doctor Name: | TRAVIS A MOTLEY |
NPI Number: | 1003850991 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 1559 |
Business Practice Address: | 855 Montgomery St Fort Worth, TX - 761072553 |
Business Phone Number: | 8177352900 |
Business Fax Number: | 8177352902 |
Mailing Address: | Po Box 99335, FORT WORTH |
State: | TX |
Postal Code: | 761990335 |
Phone Number: | 8177352900 |
Fax Number: | 8177352902 |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 09/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 1559 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |