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NPI Code Detail

MEDICARE: DR. TIMOTHY BANISTER PHARM.D.

MEDICARE: DR. TIMOTHY BANISTER PHARM.D.
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
11835X0200XOncology Pharmacist33742TX

General Provider Information

NPI Number : 1831192442
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY BANISTER PHARM.D.
Provider Business Mailing Address
First Line : 1609 HOSPITAL PKWY
Second Line :
City : BEDFORD
State : TX
Zip : 76022-6920
Country : US
Telephone Number : 817-359-9070
Fax Number : 817-359-9025
Provider Business Practice Location Address
First Line : 1609 HOSPITAL PKWY
Second Line :
City : BEDFORD
State : TX
Zip : 76022-6920
Country : US
Telephone Number : 817-359-9070
Fax Number : 817-359-9025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 06/21/2016

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