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Individual

CAROLYN J BANNISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15169 DEWBERRY LN, CONROE, TX 77302-7503
(936) 494-5079
Mailing address
15169 DEWBERRY LN, CONROE, TX 77302-7503
(936) 494-5079

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Enumeration date
09/18/2019
Last updated
09/18/2019
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