Provider Demographics
NPI:1972915684
Name:COWLEY, TRAVIS JAMES (PT, DPT)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:JAMES
Last Name:COWLEY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 AIRLINE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-3273
Mailing Address - Country:US
Mailing Address - Phone:318-519-3088
Mailing Address - Fax:318-519-3090
Practice Address - Street 1:2113 AIRLINE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-3273
Practice Address - Country:US
Practice Address - Phone:318-519-3088
Practice Address - Fax:318-519-3090
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1243386225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist