Individual provider Active NPI

Brooke Michelle Travis

  • Critical Care Pediatric Nurse Practitioner
  • Houston, TX
National Provider Identifier
1528791399
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
202213611 Issued in TX
Practice address
18200 Katy Fwy
Houston, TX 77094-1285
Phone
(817) 480-7879
NPI assigned
Jul 7, 2022
Last updated
May 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 878713 TX
Critical Care Pediatric Nurse Practitioner 363LP0222X 202213611 TX Primary

Addresses

Primary practice location

18200 Katy Fwy
Houston, TX 77094-1285

Mailing address

6007 Sandia Lake LN
Houston, TX 77041-6162
Phone (817) 480-7879

Other identifiers 1

IdentifierTypeStateIssuer
0OtherDO NOT HAVE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/A

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220825000377 TX Practitioner - Nurse Practitioner 6406230424 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202213611TXMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Aug 11, 2022 Accepting new patients
Ut Physicians CurrentSince Aug 11, 2022 Accepting new patients
Texas Children's Physician Group CurrentSince Apr 21, 2025 Accepting new patients

Locations

18200 Katy Fwy
Houston, TX 77094
Phone (832) 227-1000

6410 Fannin St
Ste 370
Houston, TX 77030
Phone (713) 486-6755

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1528791399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007 SANDIA LAKE LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770416162",
            "telephone_number": "817-480-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18200 KATY FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941285",
            "telephone_number": "817-480-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "BROOKE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "878713",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "TX",
            "license": "202213611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "18200 Katy Fwy",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770941285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.