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General NPI Number Information
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NPI Number | 1619382959
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Entity Type | Individual
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Provider Name | SHOBHANA BANKER MD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 11/14/2020
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Provider Practice Location Address
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Address Line | 2300 MARIE CURIE DR
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City | GARLAND
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State | TX
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Zip | 75042-5706
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Country | US
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Telephone | 214-857-2081
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Fax |
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Provider Business Mailing Address
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Address Line | 8108 LOCUST ST
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City | IRVING
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State | TX
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Zip | 75063-7293
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Country | US
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Telephone | 973-216-1282
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA10142000
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License Number State | NJ
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