Individual
DR. MELINDA D. BANISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4505 15TH ST, LUBBOCK, TX 79416-4809
(806) 793-3510
Mailing address
4505 15TH ST, LUBBOCK, TX 79416-4809
(806) 793-3510
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
L6775
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101068100
FIRSTCARE COMMERCIAL
TX
05
—
101068101
—
TX
05
—
158778401
—
TX
05
—
158778402
—
TX
05
—
200010850A
—
OK
01
—
201042058
PRESBYTERIAN COMMERCIAL
NM
05
—
201042058
—
NM
05
—
73734322
—
NM
01
—
87380Z
HMO BLUE
TX
01
—
8G0352
BC/BS
TX
01
—
A564
TRIWEST
NM
Enumeration date
11/30/2005
Last updated
01/22/2010
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