Provider Demographics
NPI:1851158232
Name:BANIT, SABINA DAXES
Entity type:Individual
Prefix:
First Name:SABINA
Middle Name:DAXES
Last Name:BANIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 OVERCUP CT
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-0889
Mailing Address - Country:US
Mailing Address - Phone:478-319-2644
Mailing Address - Fax:
Practice Address - Street 1:105 TRINITY PL
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607-2112
Practice Address - Country:US
Practice Address - Phone:706-549-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003596152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist