Individual
WILLIAM M BANISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 MEDI PARK DR STE 2, AMARILLO, TX 79106-2105
(806) 350-7918
Mailing address
2000 S MAYS ST STE 201, ROUND ROCK, TX 78664-7580
(512) 244-4272
(806) 350-7693
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
J1856
TX
207T00000X
Neurological Surgery Physician
Primary
J1856
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030927001
—
TX
05
—
202326901
—
TX
Enumeration date
07/04/2006
Last updated
09/09/2021
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