MEDICARE: KAMAKKI JANNI RENEE BANKS MD

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
1	207R00000X	Internal Medicine Physician	N6159	TX
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RC0000X	Cardiovascular Disease Physician	N6159	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BP1-0022646	OTHER		INSTITUTIONAL PERMIT

General Provider Information

NPI Number	:	1487863155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMAKKI JANNI RENEE BANKS MD

Provider Business Mailing Address
First Line	:	PO BOX 837
Second Line	:
City	:	HOWE
State	:	TX
Zip	:	75459-0837
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	788 S WATTERS RD STE 120
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-5123
Country	:	US
Telephone Number	:	214-399-0840
Fax Number	:	346-589-6716

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	06/25/2026

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