Provider Demographics
NPI:1679603328
Name:JONES, TRAVIS ALAN (LAT, AT,C)
Entity type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:ALAN
Last Name:JONES
Suffix:
Gender:M
Credentials:LAT, AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23747 FM 2090 RD
Mailing Address - Street 2:
Mailing Address - City:SPLENDORA
Mailing Address - State:TX
Mailing Address - Zip Code:77372-3733
Mailing Address - Country:US
Mailing Address - Phone:218-689-8008
Mailing Address - Fax:281-689-8675
Practice Address - Street 1:23747 FM 2090 RD
Practice Address - Street 2:
Practice Address - City:SPLENDORA
Practice Address - State:TX
Practice Address - Zip Code:77372-3733
Practice Address - Country:US
Practice Address - Phone:218-689-8008
Practice Address - Fax:281-689-8675
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT13532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer