Individual
MR. JEFFREY STEPHEN BANASZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6 ROGERS CT, PANTEGO, TX 76013-3167
(817) 277-1458
Mailing address
6 ROGERS CT, PANTEGO, TX 76013-3167
(817) 277-1458
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1168492
TX
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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