Individual
JESSE BANALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 NORTH SANTA ROAD, CCF-F3725, SAN ANTONIO, TX 78207
(210) 704-3910
Mailing address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 476-8559
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
R6338
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
R6338
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2015
Last updated
11/18/2022
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