Individual provider Active NPI

Travis Swann, PTA

  • Physical Therapy Assistant
  • Montgomery, TX
National Provider Identifier
1306546890
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2123751 Issued in TX
Practice address
750 Fish Creek Thoroughfare
Montgomery, TX 77316-6965
Phone
(936) 272-0790
NPI assigned
Mar 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2123751 TX Primary

Addresses

Primary practice location

750 Fish Creek Thoroughfare
Montgomery, TX 77316-6965

Mailing address

750 Fish Creek Thoroughfare
Montgomery, TX 77316-6965
Phone (936) 272-0790

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2123751TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1306546890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 FISH CREEK THOROUGHFARE",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773166965",
            "telephone_number": "936-272-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 FISH CREEK THOROUGHFARE",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773166965",
            "telephone_number": "936-272-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANN",
        "first_name": "TRAVIS",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2123751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.