MEDICARE: DR. STEVEN G BANDER DO

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	207Q00000X	Family Medicine Physician	G3129	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00AW60	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	AW60	OTHER		BCBS
4	080003644	OTHER		RR MCR
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578545026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN G BANDER DO

Provider Business Mailing Address
First Line	:	2449 COUNTY ROAD 1370
Second Line	:
City	:	BLANCHARD
State	:	OK
Zip	:	73010-4206
Country	:	US
Telephone Number	:	214-384-1631
Fax Number	:	405-265-5230

Provider Business Practice Location Address
First Line	:	217 N HARRISON AVE STE 109
Second Line	:
City	:	BLANCHARD
State	:	OK
Zip	:	73010-6217
Country	:	US
Telephone Number	:	405-888-8483
Fax Number	:	918-803-4861

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	03/02/2023

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Directions to “ DR. STEVEN G BANDER DO” Practice Location

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