Provider Demographics
NPI:1588782155
Name:LAFOREST, TRAVIS JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:JAMES
Last Name:LAFOREST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 COOK ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-1517
Mailing Address - Country:US
Mailing Address - Phone:281-772-8177
Mailing Address - Fax:281-876-2574
Practice Address - Street 1:14755 I-45 NORTH FREEWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090
Practice Address - Country:US
Practice Address - Phone:281-876-2574
Practice Address - Fax:281-876-2574
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8963111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608019OtherSOLO BCBS OF TEXAS PROVID