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General NPI Number Information
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NPI Number | 1366533952
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Entity Type | Organization
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Legal Business Name | CHAIM BANJO MD PHD PA
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 718 W MOORE AVE 101
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City | TERRELL
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State | TX
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Zip | 75160
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Country | US
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Telephone | 972-551-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 718 W MOORE AVE 101
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City | TERRELL
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State | TX
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Zip | 75160
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Country | US
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Telephone | 972-551-1900
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHAIM BANJO
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Credential | MD PHD
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Telephone | 972-686-7947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G4442
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License Number State | TX
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