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NPI Code Detail

MEDICARE: DR. BRENT STEPHEN BANKS DPM

MEDICARE:  DR. BRENT STEPHEN BANKS  DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist1922TX
2213ES0103XFoot & Ankle Surgery Podiatrist016005419IL

General Provider Information

NPI Number : 1205066461
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRENT STEPHEN BANKS DPM
Provider Business Mailing Address
First Line : 1307 8TH AVE STE 407
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4107
Country : US
Telephone Number : 817-776-5333
Fax Number : 817-380-2428
Provider Business Practice Location Address
First Line : 1307 8TH AVE STE 407
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4107
Country : US
Telephone Number : 817-776-5333
Fax Number : 817-380-2428
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2009
Last Update Date : 12/27/2021

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Directions to “ DR. BRENT STEPHEN BANKS DPM” Practice Location

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