MEDICARE: MATTHEW BANKS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	J6318	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8EH091	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326041617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW BANKS MD

Provider Business Mailing Address
First Line	:	PO BOX 840853
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-0853
Country	:	US
Telephone Number	:	971-233-1999
Fax Number	:	972-233-3666

Provider Business Practice Location Address
First Line	:	4144 N CENTRAL EXPY
Second Line	:	STE. 360
City	:	DALLAS
State	:	TX
Zip	:	75204
Country	:	US
Telephone Number	:	214-252-3511
Fax Number	:	214-826-6858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	05/30/2018

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