Healthcare Provider Details

I. General information

NPI: 1588756332
Provider Name (Legal Business Name): DELIA ESTHER BANCHS MPH, BS, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S 1ST ST CENTRAL TX VETERANS HEALTH CARE SYSTEM
TEMPLE TX
76504-7451
US

IV. Provider business mailing address

402 GINA DR
HARKER HEIGHTS TX
76548-6087
US

V. Phone/Fax

Practice location:
  • Phone: 254-743-0712
  • Fax: 254-743-0135
Mailing address:
  • Phone: 254-698-2086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA01405
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: