Healthcare Provider Details

I. General information

NPI: 1023109071
Provider Name (Legal Business Name): ERNEST LEONARD BANKS MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 HORIZON HILL BLVD
SAN ANTONIO TX
78229-2258
US

IV. Provider business mailing address

4455 HORIZON HILL BLVD
SAN ANTONIO TX
78229-2258
US

V. Phone/Fax

Practice location:
  • Phone: 210-321-2700
  • Fax: 210-321-2705
Mailing address:
  • Phone: 210-321-2700
  • Fax: 210-321-2705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: