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General NPI Number Information
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NPI Number | 1134540438
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Entity Type | Individual
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Provider Name | JESSIE ALEXANDRA BANGS MD, L.AC.
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Gender | Female
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Dates
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Enumeration Date | 01/04/2014
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 4900 MUELLER BLVD
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City | AUSTIN
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State | TX
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Zip | 78723-3051
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Country | US
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Telephone | 512-324-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 MUELLER BLVD
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City | AUSTIN
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State | TX
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Zip | 78723-3051
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC01498
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | T4708
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10072954
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | T4708
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License Number State | TX
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