Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 10762 | TX |
NPI | 1013948629 |
---|---|
Provider Name | Dr. Cynthia A Banker |
First Address | San Antonio, TX 78232-2232 |
Second Address | San Antonio, TX 78232-2232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 09/07/2007 |