Provider Demographics
NPI:1316724834
Name:TRIBE TRAVIS, LLC
Entity type:Organization
Organization Name:TRIBE TRAVIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GHASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALYASSIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-305-2771
Mailing Address - Street 1:7 RIVERWAY UNIT 603
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-1972
Mailing Address - Country:US
Mailing Address - Phone:877-305-2771
Mailing Address - Fax:
Practice Address - Street 1:7 RIVERWAY UNIT 603
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-1972
Practice Address - Country:US
Practice Address - Phone:877-305-2771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty