Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | M3887 | TX |
NPI | 1356331656 |
---|---|
Provider Name | Dr. Kevin Patrick Banks |
First Address | Jbsa Ft Sam Houston, TX 78234-4505 |
Second Address | Ft Sam Houston, TX 78261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 20/09/2019 |