Travis Moffatt OD PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TRAVIS MOFFATT OD PLLC

Practice address

18423 FM 1488 Rd Ste D
Magnolia, TX 77354-8512

Phone

(346) 386-0100

Fax

(346) 386-0109

NPI assigned

May 19, 2020

Organization subpart

No

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

Authorized official

Name

Travis Moffatt, ODNPI 1730263013

Title

Owner

Phone

(281) 635-4978

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Travis Moffatt, O.D.

  • Optometrist
  • Magnolia, TX
  • NPI 1730263013
  Medicare reassignment Care Compare group NPD Authorized official
• Lindsey Marie Mills, O.D.

  • Optometrist
  • Humble, TX
  • NPI 1356696306
  Medicare reassignment Care Compare group NPD
• Annalisa Erder-Mikel, OD

  • Optometrist
  • Magnolia, TX
  • NPI 1568075679
  NPD

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1760005375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18423 FM 1488 RD STE D",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773548512",
            "telephone_number": "346-386-0100",
            "fax_number": "346-386-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18423 FM 1488 RD STE D",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773548512",
            "telephone_number": "346-386-0100",
            "fax_number": "346-386-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS MOFFATT OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-19",
        "last_updated": "2024-03-06",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "MOFFATT",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-635-4978",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Magnolia, TX
• Providers in Magnolia, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.