| Denise Cantu Bannister, M.d.,p.a. | |
|
403 W Campbell Rd Ste. 410 Richardson TX 75080-3465 | |
| (972) 498-8670 | |
| (972) 498-8676 |
| Full Name | Denise Cantu Bannister, M.d.,p.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 403 W Campbell Rd, Richardson, Texas |
| Authorized Official Name and Position | Denise Cantu Bannister (PRESIDENT) |
| Authorized Official Contact | 9724988670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Denise Cantu Bannister, M.d.,p.a. 403 W Campbell Rd Ste. 410 Richardson TX 75080-3465 Ph: (972) 498-8670 | Denise Cantu Bannister, M.d.,p.a. 403 W Campbell Rd Ste. 410 Richardson TX 75080-3465 Ph: (972) 498-8670 |
| NPI Number | 1558666016 |
|---|---|
| Provider Enumeration Date | 01/14/2011 |
| Last Update Date | 01/14/2011 |
| Medicare PECOS PAC ID | 5698955490 |
|---|---|
| Medicare Enrollment ID | O20110211000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558666016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | J8482 (Texas) | Primary |
| Provider Name | Denise Cantu Bannister |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326059130 PECOS PAC ID: 6507046307 Enrollment ID: I20110211000056 |
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