Dr Ethan Scott Bannar, PSYD is a
Psychologist - Clinical based in Goodfellow Afb, Texas. Dr Ethan Scott Bannar is licensed to practice in Virginia (license number 0810007978) and his current practice location is
271 Ft Richardson Ave, Goodfellow Afb, Texas. He can be reached at his office (for appointments etc.) via phone at
(325) 654-3122.
NPI number for Dr Ethan Scott Bannar is 1467962928 and his current mailing address is 271 Ft Richardson Ave, Goodfellow Air Force Base, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1467962928.
Healthcare Provider's Profile
Full Name | Dr Ethan Scott Bannar |
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Gender | Male |
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Speciality | Psychologist - Clinical |
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Location | 271 Ft Richardson Ave, Goodfellow Afb, Texas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1467962928
- Provider Enumeration Date: 10/10/2017
- Last Update Date: 07/13/2023
Medical Identifiers
Medical identifiers for Dr Ethan Scott Bannar such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1467962928 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
103TC0700X | Psychologist - Clinical | 0810007978 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ethan Scott Bannar is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Ethan Scott Bannar, PSYD 271 Ft Richardson Ave, Goodfellow Air Force Base, TX 76908 Ph: (325) 654-3122 | Dr Ethan Scott Bannar, PSYD 271 Ft Richardson Ave, Goodfellow Afb, TX 76908 Ph: (325) 654-3122 |
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