Provider Demographics
NPI:1841232444
Name:BANARER, SALOMON (MD)
Entity type:Individual
Prefix:DR
First Name:SALOMON
Middle Name:
Last Name:BANARER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN STE C340
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-6897
Mailing Address - Country:US
Mailing Address - Phone:972-566-7799
Mailing Address - Fax:972-566-7399
Practice Address - Street 1:7777 FOREST LN STE C340
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-6897
Practice Address - Country:US
Practice Address - Phone:972-566-7799
Practice Address - Fax:972-566-7399
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1490207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
10802179OtherCAQH
TX8U4150OtherBCBS
TX8U4150OtherBCBS
TXH65206Medicare UPIN