TRAVIS HOUSEHOLDER

ALBUQUERQUE, NM
NPI1285032367
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  018279)
Enumeration Date2014-12-05
Last Update Date2015-12-07
Business Address
-- TRAVIS HOUSEHOLDER PA-C
201 CEDAR ST SE STE 4610 PRESBYTERIAN HEART GROUP
ALBUQUERQUE, NM 87106-4936
Phone number: 505-563-2500
Mailing Address
-- TRAVIS HOUSEHOLDER PA-C
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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