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NPI Code Detail

MEDICARE: PABITRA BANSKOTA DDS

MEDICARE: PABITRA BANSKOTA DDS
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
11223G0001XGeneral Practice Dentistry29943TX

General Provider Information

NPI Number : 1306259064
Entity Type Code : Individual
Provider Name (Legal Business Name) : PABITRA BANSKOTA DDS
Provider Business Mailing Address
First Line : 3750 COMMERCIAL AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78221-3117
Country : US
Telephone Number : 210-922-7000
Fax Number : 210-457-3396
Provider Business Practice Location Address
First Line : 5439 RAY ELLISON BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78242-2219
Country : US
Telephone Number : 210-922-7000
Fax Number : 210-457-3396
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2014
Last Update Date : 05/20/2020

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Directions to “ PABITRA BANSKOTA DDS” Practice Location

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