Individual
DR. ELOISA YU BANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 STADIUM DRIVE, SEYMOUR, TX 76380
(940) 889-5572
(940) 889-3337
Mailing address
201 STADIUM DR, SEYMOUR, TX 76380
(940) 889-5572
(940) 889-3337
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G0347
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110034454
RAILROAD MEDICARE PIN
TX
05
—
130795102
—
TX
05
—
130795107
—
TX
01
—
BA000H65L
BLUE CROSS
TX
Enumeration date
10/26/2005
Last updated
10/30/2017
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