Provider Demographics
NPI:1073821054
Name:PARENDRA P BANKER MD PA
Entity Type:Organization
Organization Name:PARENDRA P BANKER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARENDRA
Authorized Official - Middle Name:PYAREKRISHNA
Authorized Official - Last Name:BANKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-446-9000
Mailing Address - Street 1:18955 N MEMORIAL DR
Mailing Address - Street 2:SUITE NUMBER 470
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4271
Mailing Address - Country:US
Mailing Address - Phone:281-446-9000
Mailing Address - Fax:281-446-8194
Practice Address - Street 1:18955 N MEMORIAL DR
Practice Address - Street 2:SUITE NUMBER 470
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4271
Practice Address - Country:US
Practice Address - Phone:281-446-9000
Practice Address - Fax:281-446-8194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2636207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1073821054Medicare PIN
TXB21081Medicare UPIN
TX00SZ49Medicare PIN