Provider Demographics
NPI:1760864185
Name:BANKSTON, STEPHANIE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BANKSTON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13620 NW MILITARY HWY
Mailing Address - Street 2:BLDG 202 STE. 8
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1167
Mailing Address - Country:US
Mailing Address - Phone:726-234-0745
Mailing Address - Fax:210-987-8591
Practice Address - Street 1:13620 NW MILITARY HWY
Practice Address - Street 2:BLDG 202 STE. 8
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1167
Practice Address - Country:US
Practice Address - Phone:726-234-0745
Practice Address - Fax:210-987-8591
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129905363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health