Provider Demographics
NPI:1861069171
Name:HINKEL, TRAVIS JAY
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:JAY
Last Name:HINKEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7019 COLDSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4486
Mailing Address - Country:US
Mailing Address - Phone:281-299-2546
Mailing Address - Fax:
Practice Address - Street 1:7019 COLDSTREAM DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4486
Practice Address - Country:US
Practice Address - Phone:281-299-2546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-06
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT132237225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist