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General NPI Number Information
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NPI Number | 1851158232
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Entity Type | Individual
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Provider Name | SABINA DAXES BANIT
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Gender | Female
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 105 TRINITY PL
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City | ATHENS
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State | GA
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Zip | 30607-2112
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Country | US
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Telephone | 706-549-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 261 OVERCUP CT
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City | ATHENS
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State | GA
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Zip | 30606-0889
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Country | US
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Telephone | 478-319-2644
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003596
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License Number State | GA
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