1275094856 NPI number — DR. TRAVIS CARLISLE SIMMONS MD

Table of content: DR. ISAAC I COHEN MD (NPI 1023015419)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275094856 NPI number — DR. TRAVIS CARLISLE SIMMONS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIMMONS
Provider First Name:
TRAVIS
Provider Middle Name:
CARLISLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275094856
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/25/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
391 LANDA ST STE 1104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BRAUNFELS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78130-7486
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-327-0171
Provider Business Mailing Address Fax Number:
830-240-9354

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2967 OAK RUN PKWY STE 505
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BRAUNFELS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78132-5454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-327-0171
Provider Business Practice Location Address Fax Number:
830-240-9354
Provider Enumeration Date:
03/27/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  T6041 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: DR.0065665 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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