Active NPI
Travis David Wilson, M.D.
- Anesthesiology Physician
- San Antonio, TX
National Provider Identifier
1154532729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- N6770
- Practice address
- 4502 Medical Dr
San Antonio, TX 78229-4402 - Phone
- (210) 450-9000
- NPI assigned
- May 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01058872A | IN | |
| Anesthesiology Physician | 207L00000X | N6770 | TX | Primary |
Addresses
Primary practice location
4502 Medical Dr
San Antonio, TX 78229-4402
Mailing address
7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 450-9000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220554401 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01058872A | IN | MD | Anesthesiology Physician |
| N6770 | TX | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas Health Science Center at San Antonio | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- San Antonio, TX
- NPI 1720051717
Anesthesiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309305600000",
"number": "1154532729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7703 FLOYD CURL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293901",
"telephone_number": "210-450-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-450-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TRAVIS",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-25",
"last_updated": "2011-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01058872A",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "N6770",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "220554401",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.