Individual
DR. CHAIM BANJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
718 W MOORE AVE STE 101, TERRELL, TX 75160-3130
(972) 551-1900
(972) 551-1974
Mailing address
718 W MOORE AVE STE 101, TERRELL, TX 75160-3130
(972) 551-1900
(972) 551-1974
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G4442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G25
BCBS
TX
05
—
109453401
—
TX
05
—
128058802
—
TX
05
—
128058803
—
TX
05
—
128058804
—
TX
01
—
1588730121
MEDICARE
—
01
—
82G516
BCBS
TX
01
—
85A011
BCBS
TX
Enumeration date
11/27/2006
Last updated
08/30/2023
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