Provider Demographics
NPI:1558662551
Name:BANKS, PATRINA (RN)
Entity Type:Individual
Prefix:MS
First Name:PATRINA
Middle Name:
Last Name:BANKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15507 MONTESA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5045
Mailing Address - Country:US
Mailing Address - Phone:281-686-3902
Mailing Address - Fax:
Practice Address - Street 1:13527 NOBLE LANDING LN
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-0409
Practice Address - Country:US
Practice Address - Phone:281-686-3902
Practice Address - Fax:281-686-3902
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-06
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX619525163W00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163W00000XNursing Service ProvidersRegistered Nurse