Charles Jack Banta Ii
Orthopaedic Spine Surgeon
8220 Walnut Hill Ln Ste 608
Dallas
, Texas 75231-4424
Charles Jack Banta Ii
Orthopaedic Spine Surgeon
8220 Walnut Hill Ln Ste 608
Dallas
, Texas 75231-4424
(214) 987-3799
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About
Features
Specialties
- Orthopaedic Spine Surgeon
Languages spoken
- English
Location
First Address
- Charles Jack Banta Ii
- 8220 Walnut Hill Ln Ste 608
- Dallas, TX
- Zip : 75231-4424
- Fax : (214) 987-3799
- Phone : (214) 987-3434
Second Address
- Charles Jack Banta Ii
- 8220 Walnut Hill Ln Ste 608
- Dallas, TX
- Zip : 75231-4424
- Fax : (214) 987-3799
- Phone : (214) 987-3434
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XS0117X | Orthopaedic Spine Surgeon | J0438 | TX |
National Provider Identifier
| NPI | 1205848512 |
|---|---|
| Provider Name | Charles Jack Banta Ii |
| First Address | Dallas, TX 75231-4424 |
| Second Address | Dallas, TX 75231-4424 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/08/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 81W560 | BLUE CROSS (01) | TX |
| E95106 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.