TRAVIS LEE WACHA FNP-BC PMHNP-BC NPI 1104374297

NPI Information

NPI: 1104374297
Provider Name: TRAVIS LEE WACHA, FNP-BC, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
4659 FM 1990
PALESTINE, TX
ZIP 75801
Phone: (903) 213-2216
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Travis Lee Wacha, FNP-BC, PMHNP-BC is a psychiatric/mental health nurse practitioner in Palestine, TX. Travis Lee Wacha, FNP-BC, PMHNP-BC NPI is 1104374297. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4659 FM 1990
PALESTINE, TX
ZIP 75801-162
Phone: (903) 213-2216
Fax: (903) 213-9233

The NPI 1104374297 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/16/2016 and was last updated on 6/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP131990	TEXAS	Yes
2	363LF0000X	Nurse Practitioner	Family	AP131990	TEXAS	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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