Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 21503 | TX |
NPI | 1619056983 |
---|---|
Provider Name | Dr. Jennifer M Bankler |
First Address | San Antonio, TX 78205-2409 |
Second Address | San Antonio, TX 78224-2124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 09/07/2007 |