Provider Demographics
NPI:1710958384
Name:BANKS, NANCY BEAMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:BEAMAN
Last Name:BANKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:ALICE
Other - Last Name:BEAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3445 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1678
Mailing Address - Country:US
Mailing Address - Phone:512-579-4000
Mailing Address - Fax:512-439-2814
Practice Address - Street 1:3445 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1678
Practice Address - Country:US
Practice Address - Phone:512-579-4000
Practice Address - Fax:512-439-2814
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01057706A207ZP0102X
TXP2587207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX344710401Medicaid
TX344710401Medicaid