Provider Demographics
NPI:1124585252
Name:BANKS, MELBA M
Entity Type:Individual
Prefix:
First Name:MELBA
Middle Name:M
Last Name:BANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 SADDLEBACK SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2253
Mailing Address - Country:US
Mailing Address - Phone:832-792-9130
Mailing Address - Fax:
Practice Address - Street 1:226 SADDLEBACK SPRINGS DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2253
Practice Address - Country:US
Practice Address - Phone:832-792-9130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253J00000XAgenciesFoster Care Agency