Provider Demographics
NPI:1447243688
Name:BANG, LINDA S (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:BANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5941 DALLAS PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-9001
Mailing Address - Country:US
Mailing Address - Phone:972-758-4455
Mailing Address - Fax:972-758-4433
Practice Address - Street 1:5941 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-9001
Practice Address - Country:US
Practice Address - Phone:972-758-4455
Practice Address - Fax:972-758-4433
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226557-1207R00000X
TXL5238207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02423921Medicaid
8G3676OtherMEDICARE PROVIDER NUMBER
NY02423921Medicaid