Provider Demographics
NPI:1588207724
Name:BANKS, ISAAC (DC)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:BANKS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 GLADSTELL RD APT 610
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2782
Mailing Address - Country:US
Mailing Address - Phone:419-631-2283
Mailing Address - Fax:
Practice Address - Street 1:26406 OAK RIDGE DR STE 101
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-1965
Practice Address - Country:US
Practice Address - Phone:832-813-8783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14241111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor