Doctor Name: | DR. TRAVIS J BLANCHARD |
NPI Number: | 1013107168 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 200926 |
Business Practice Address: | 1101 6th Ave Ft Worth, TX - 761044306 |
Business Phone Number: | 8173364638 |
Business Fax Number: | 8173327349 |
Mailing Address: | 1101 6th Ave, FT WORTH |
State: | TX |
Postal Code: | 761044306 |
Phone Number: | 8173364638 |
Fax Number: | 8173327349 |
NPI Enumeration Date: | 07/25/2007 |
NPI Last Update Date: | 01/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 200926 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |