Provider Demographics
NPI:1619466935
Name:HB PURE HEALTH, PLLC.
Entity Type:Organization
Organization Name:HB PURE HEALTH, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HADELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-413-4813
Mailing Address - Street 1:8404 PRESTON RD STE 208
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3332
Mailing Address - Country:US
Mailing Address - Phone:440-413-4813
Mailing Address - Fax:888-435-5331
Practice Address - Street 1:8404 PRESTON RD STE 208
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3332
Practice Address - Country:US
Practice Address - Phone:440-413-4813
Practice Address - Fax:888-435-5331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty