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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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