Individual
DR. BANNIE LEE TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 PENNSYLVANIA AVE, SUITE 600, FORT WORTH, TX 76104-2158
(817) 878-5298
(817) 878-5289
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
G3834
TX
Other
Enumeration date
04/25/2006
Last updated
09/27/2011
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