Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 11258 | TX |
NPI | 1043536600 |
---|---|
Provider Name | Dr. Nathan Chase Banks |
First Address | Spring, TX 77382-2301 |
Second Address | Shenandoah, TX 77381-1118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2010 |
Last Update Date | 07/04/2010 |