Travis Conklin, OPA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

757 - OPA-C CERT #

Practice address

7777 Forest LN
Suite C-106
Dallas, TX 75230-2505

Phone

(214) 823-7090

Fax

(214) 823-1644

NPI assigned

Apr 13, 2007

Last updated

Oct 8, 2008By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: tconklin@direct.uspi.com

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1659596922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650500",
            "telephone_number": "214-369-8555",
            "fax_number": "214-369-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "SUITE C-106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "214-823-7090",
            "fax_number": "214-823-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "TRAVIS",
        "credential": "OPA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "757 - OPA-C CERT #",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": "CERT 757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Congenital Heart Surgery Center PLLC
• Holly Conger, MD
• Congo Dental Clinic P.a.
• Carolyn Conklin, NP-C
• Leilani Ivette Conklin
• Bonita Williams Conley, RN, PNP-BC
• Conlon Plastic Surgery PLLC
• Adam Conlon, CRNA
• Christopher John Conlon
• Lucia Conlon, DO

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.