Provider Demographics
NPI:1134488877
Name:BANANI, NAUSHAD PYARALI (DPM)
Entity Type:Individual
Prefix:DR
First Name:NAUSHAD
Middle Name:PYARALI
Last Name:BANANI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5900 SOUTH LAKE FOREST DRIVE SUITE 300 PMB 2010
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2238
Mailing Address - Country:US
Mailing Address - Phone:469-443-4241
Mailing Address - Fax:833-471-5540
Practice Address - Street 1:5900 SOUTH LAKE FOREST DRIVE
Practice Address - Street 2:SUITE 300 PMB 2010
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2238
Practice Address - Country:US
Practice Address - Phone:469-443-4241
Practice Address - Fax:833-471-5540
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5356213ES0103X
TX2298213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE5356OtherCALIFORNIA PODIATRY LICENSE
TX2298OtherTEXAS PODIATRY LICENSE