TRAVIS HOUSEHOLDER (NPI# 1285032367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285032367 |
| Entity Type | Individual |
| Full Name | TRAVIS HOUSEHOLDER |
| Credential | PA-C |
| Practice Address |
201 Cedar St Se Ste 4610 Presbyterian Heart Group Albuquerque NM 87106-4936 |
| Mailing Address |
Po Box 26666 Phs Provider Enrollment Albuquerque NM 87125-6666 |
| Practice Telephone | 5055632500 |
| Practice Fax Number | 5055632599 |
| Mailing Telephone | 5059236770 |
| Mailing Fax Number | 5059235354 |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2015-12-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 018279 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
201 CEDAR ST SE STE 4610 PRESBYTERIAN HEART GROUP |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87106-4936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679808 | Jorge Licano | Student in an Organized Health Care Education/Training Program | Unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-04 |
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1336746205 | Evan Laub | Pharmacist | 2950 Central Ave. Sw, Albuquerque, NM 87106 | 2020-10-05 |
| 1487203154 | Theresa Martinez | Technician | 5680 Avedon Dr. Se, Albuquerque, NM 87106 | 2019-09-05 |
| 1205300647 | Louis Mayer II | Specialist/Technologist | 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 | 2019-01-18 |
| 1235633355 | Terrena Grace Vigil Brady | Occupational Therapist | 1001 Yale Blvd, Albuquerque, NM 87106 | 2018-03-22 |
| 1205355195 | Yaritza Ruiz | Specialist/Technologist | 1200 Avenida Cesar Chavez, 231d, Albuquerque, NM 87106 | 2017-09-12 |
| 1457873382 | Cynthia Bluhm | Registered Nurse | 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 | 2017-07-12 |
| 1295265882 | Hallie Chancellor | Behavior Technician | 1801 Gibson Blvd Se Apt 1046, Albuquerque, NM 87106 | 2017-06-15 |
| 1780111757 | Jiana Hook | Physical Medicine & Rehabilitation | 1414 University Blvd. Se, Albuquerque, NM 87106 | 2017-05-22 |
| Find all providers in zip 87106 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474550 | Mara Swartzentruber | Physician Assistant | 3310 Linda Vista Ave Se, Albuquerque, NM 87106-1514 | 2020-10-13 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1487287413 | Thomas Clise | Physician Assistant | 629 San Pablo St Ne, Albuquerque, NM 87108-2137 | 2020-02-18 |
| 1912547324 | Kathleen Joyce L'heureux | Physician Assistant | 8124 Ventana Cielo Ave Nw, Albuquerque, NM 87114-5988 | 2020-01-14 |
| 1265097869 | Amber Zoubovitch | Physician Assistant | 7200 Montgomery Blvd Ne Ste 7121, Albuquerque, NM 87109-1510 | 2019-05-08 |
| 1639680739 | Wesley A Parker | Physician Assistant | 3777 Mdg, 2050a Second Street Se, Albuquerque, NM 87117-5522 | 2017-10-16 |
| 1003327487 | Elise Nicole Pedigo | Physician Assistant | 4700 Jefferson St Ne Ste 700, Albuquerque, NM 87109-2132 | 2017-10-12 |
| 1194170605 | Anna Marie Siow | Physician Assistant | 1014 Hummingbird Pl Sw, Albuquerque, NM 87105-8130 | 2016-05-03 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| 1588002778 | Paige Reynolds O'connor | Physician Assistant | 4221 Montgomery Blvd Ne, Albuquerque, NM 87109-1103 | 2013-06-10 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87106 |
Please comment or provide details below to improve the information on TRAVIS HOUSEHOLDER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.