Banner, Mary Christine
Banner, Mary Christine is an individual health care provider with primary practice located at 901 7Th Ave , Fort Worth TX 76104-2722. She recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as her primary health care specialty. Banner, Mary Christine can be contacted via phone (682) 885-1050.Contact Information
Primary practice address
901 7Th Ave
Fort Worth TX 76104-2722
Phone: (682) 885-1050
Fax: (682) 885-7572
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | K2217 | Texas |
Profile Details
| NPI number | 1508941691 |
|---|---|
| LBN Legal business name | Banner, Mary Christine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2006 |
| Last updated | May 6th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508941691 | NPPES |
| Texas | Other | 10011835 | AMERIGROUP PIN |
| Texas | Other | 124029 | AMERIGROUP PIN |
| Texas | Other | 043860808 | AMERIGROUP PIN |
| Texas | Other | 1727210 | AMERIGROUP PIN |
| Texas | Other | 413461 | AMERIGROUP PIN |
| Texas | MEDICAID | 043860807 | AMERIGROUP PIN |
| Texas | Other | 00U87Z | AMERIGROUP PIN |
| Texas | Other | 85381B | AMERIGROUP PIN |
| Texas | Other | 1750369203 | AMERIGROUP PIN |
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