Travis Lee Wacha, FNP-BC, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP131990 Issued in TX

Practice address

4659 FM 1990
Palestine, TX 75801-1162

Phone

(903) 213-2216

Fax

(903) 213-9233

NPI assigned

Sep 16, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: travis_wacha_np@yourcarecommunity.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Texas Neurobehavioral Health,PLLC

  • Clinical Psychologist
  • Gun Barrel City, TX
  • NPI 1114285970
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1104374297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 FM 1990",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758011102",
            "telephone_number": "903-724-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4659 FM 1990",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758011162",
            "telephone_number": "903-213-2216",
            "fax_number": "903-213-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHA",
        "first_name": "TRAVIS",
        "middle_name": "LEE",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-16",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP131990",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131990",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Layne Vannoy, RPH
• Alana Leigh Varela, FNP
• Laura Velazquez
• Michael Venable, PHARMD, RPH
• Dianna Vernon, LMT, NMT
• Gary M Waddell, M.D.
• Kelsee Wade, DC
• Richard Wagner, M.D.
• Wendy R Wagner, OTR
• Wal-Mart Stores Texas LLC

• Psychiatric/Mental Health Nurse Practitioner in Palestine, TX
• Providers in Palestine, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.