Organization Active NPI

Travis Medical Sales Corporation

  • Durable Medical Equipment & Medical Supplies
  • San Angelo, TX
National Provider Identifier
1457681298
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
TRAVIS MEDICAL SALES CORPORATION
Practice address
1724 Sunset Dr
San Angelo, TX 76904-7104
Phone
(325) 223-6400
Fax
(325) 223-6404
NPI assigned
Dec 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Authorized official

Name
Jeffrey Matukewicz
Title
Secretary
Phone
(423) 756-2268

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X

Addresses

Primary practice location

1724 Sunset Dr
San Angelo, TX 76904-7104

Mailing address

5959 Shallowford Rd Ste 443
Chattanooga, TN 37421-2245
Phone (423) 756-2268

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1457681298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 SHALLOWFORD RD STE 443",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212245",
            "telephone_number": "423-756-2268",
            "fax_number": "423-362-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 SUNSET DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047104",
            "telephone_number": "325-223-6400",
            "fax_number": "325-223-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS MEDICAL SALES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "MATUKEWICZ",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "423-756-2268"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.