Provider Demographics
NPI:1497906713
Name:BANKS, MYESHA D (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:MYESHA
Middle Name:D
Last Name:BANKS
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10410 ROYAL CHAPEL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5040
Mailing Address - Country:US
Mailing Address - Phone:614-832-0761
Mailing Address - Fax:
Practice Address - Street 1:9301 N CENTRAL EXPY STE 410
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0805
Practice Address - Country:US
Practice Address - Phone:972-993-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117170363LW0102X, 207QS0010X
TX758414363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health