Provider Demographics
NPI:1437710480
Name:LIVINGSTON, TRAVIS WOODROW (DO)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:WOODROW
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:TRAVIS
Other - Middle Name:WOODROW
Other - Last Name:LIVINGSTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-1395
Mailing Address - Country:US
Mailing Address - Phone:281-614-1256
Mailing Address - Fax:281-614-1587
Practice Address - Street 1:4001 COLISEUM DR STE 300
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6257
Practice Address - Country:US
Practice Address - Phone:757-827-2025
Practice Address - Fax:757-275-9802
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102207503207Q00000X
TXBP10066732207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine