Provider Demographics
NPI:1144581331
Name:BANNER, JENNA N (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:N
Last Name:BANNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11212 STATE HIGHWAY 151, SUITE 350
Mailing Address - Street 2:PLAZA 2
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251
Mailing Address - Country:US
Mailing Address - Phone:210-281-5066
Mailing Address - Fax:210-281-4459
Practice Address - Street 1:7950 FLOYD CURL DRIVE
Practice Address - Street 2:SUITE 801
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-281-5066
Practice Address - Fax:210-281-4459
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXQ7638207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3677395601Medicaid