Provider Demographics
NPI:1073245429
Name:BANSAL, MINAKSHI (DNP)
Entity Type:Individual
Prefix:DR
First Name:MINAKSHI
Middle Name:
Last Name:BANSAL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 E STATE HIGHWAY 121 STE 220
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-7958
Mailing Address - Country:US
Mailing Address - Phone:972-745-7500
Mailing Address - Fax:972-745-4376
Practice Address - Street 1:611 E STATE HIGHWAY 121 STE 220
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-7958
Practice Address - Country:US
Practice Address - Phone:972-745-7500
Practice Address - Fax:972-745-4376
Is Sole Proprietor?:No
Enumeration Date:2022-06-25
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1083733363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily