Individual provider Active NPI

William Richard Travis, MD

  • Internal Medicine Physician
  • Irving, TX
National Provider Identifier
1700804937
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H8954 Issued in TX
Practice address
4545 Fuller Dr Ste 325
Irving, TX 75038-6530
Phone
(972) 870-5511
Fax
(972) 870-5512
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H8954 TX Primary

Addresses

Primary practice location

4545 Fuller Dr Ste 325
Irving, TX 75038-6530

Mailing address

4545 Fuller Dr Ste 325
Irving, TX 75038-6530

Other practice location 1

7800 Shoal Creek Blvd Ste 130W
Austin, TX 78757-1040
Phone (512) 407-8880

Other identifiers 1

IdentifierTypeStateIssuer
034025903MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050805000586 TX Practitioner - Internal Medicine 0547299943 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H8954TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Jul 14, 2014 Accepting new patients
Iah of Texas, PLLC CurrentSince Jan 1, 2015 Accepting new patients
Vpa of Texas PLLC CurrentSince Jul 14, 2014 Accepting new patients
Vpa of Texas PLLC Internal Medicine Current Accepting new patients
Physicians and Allied Health Professionals Group, PA Internal Medicine Past Accepting new patients
Stonebridge Foot & Ankle, P.L.L.C. Past Accepting new patients

Locations

7800 Shoal Creek Blvd
Ste 118W
Austin, TX 78757
Phone (512) 374-0700

7800 Shoal Creek Blvd
Ste 130W
Austin, TX 78757
Phone (713) 874-0012

1301 W 7th St
Ste 121
Ft Worth, TX 76102
Phone (817) 348-0425

8588 Katy Fwy
Ste 226A
Houston, TX 77024
Phone (713) 532-6884

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

5414 Fredericksburg Rd
Ste 100A
San Antonio, TX 78229
Phone (210) 468-0800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12425/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1700804937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 FULLER DR STE 325",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750386530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 FULLER DR STE 325",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750386530",
            "telephone_number": "972-870-5511",
            "fax_number": "972-870-5512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7800 Shoal Creek Blvd Ste 130W",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787571040",
            "country_code": "US",
            "telephone_number": "512-407-8880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "WILLIAM",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H8954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034025903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.