Provider Demographics
NPI:1235143058
Name:TRAVIS, ZANE ROLAND (MD)
Entity type:Individual
Prefix:DR
First Name:ZANE
Middle Name:ROLAND
Last Name:TRAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1156 ELMWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605
Mailing Address - Country:US
Mailing Address - Phone:325-692-5600
Mailing Address - Fax:325-734-5370
Practice Address - Street 1:850 N 6TH STREET
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601
Practice Address - Country:US
Practice Address - Phone:325-692-5600
Practice Address - Fax:325-734-5370
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXC7146207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C22759Medicare UPIN