MEDICARE: FATMA BANDAY

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	1223P0300X	Periodontics	42416	TX

General Provider Information

NPI Number	:	1619893617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATMA BANDAY

Provider Business Mailing Address
First Line	:	3310 OAKWELL CT APT 31104
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-5102
Country	:	US
Telephone Number	:	929-499-4350
Fax Number	:

Provider Business Practice Location Address
First Line	:	4466 LOCKHILL SELMA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2078
Country	:	US
Telephone Number	:	210-236-8672
Fax Number	:

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

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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Directions to “ FATMA BANDAY ” Practice Location

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