CHARLES JACK BANTA II


Address: 8220 Walnut Hill Ln Ste 608, Dallas, TX 75231-4424
Phone: 2149873434

CHARLES JACK BANTA II (NPI# 1205848512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205848512
Entity Type Individual
Full Name CHARLES JACK BANTA II
Credential MD
Practice Address 8220 Walnut Hill Ln Ste 608
Dallas
TX 75231-4424
Practice Telephone 2149873434
Practice Fax Number 2149873799
Mailing Telephone 2149873434
Mailing Fax Number 2149873799
Enumeration Date 2006-08-13
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207XS0117X Orthopaedic Surgery
Specialization: Orthopaedic Surgery of the Spine
J0438 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX BLUE CROSS 81W560 01

Office Location

Street Address 8220 WALNUT HILL LN STE 608
City DALLAS
State TX
Zip Code 75231-4424

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NPI Name Taxonomy Address Enumeration
1659987022 Specialists In Geriatric and Palliative Care Medicine Pllc Clinic/Center 8198 Walnut Hill Lane, Jackson Bldg, Suite 100, Dallas, TX 75231 2020-09-21
1013546118 The Legacy Midtown Park, Inc Skilled Nursing Facility 8280 Manderville Lane, Dallas, TX 75231 2020-04-02
1003383373 Northeast Dallas Dentistry, PC Dentist 6401 East Northwest Highway, Suite 100, Dallas, TX 75231 2018-10-25
1518442565 Daniel Max & Marc Andrea LLC Optometrist 6471 E Northwest Hwy, Dallas, TX 75231 2018-09-26
1760964100 Amber Nicole Caruthers Nurse Practitioner 8060 Park Lane, Dallas, TX 75231 2018-09-01
1376024893 Brittany Leigh Stedman Physical Therapist 8130 Meadow Rd, Dallas, TX 75231 2018-08-23
1700367224 Tia Cornelius Occupational Therapy Assistant 8130 Meadow Rd., Dallas, TX 75231 2018-08-23
1538653753 Manju R. Goyal M.d. Psychiatry Pllc Psychiatry & Neurology 5477 Glen Lakes Dr Ste 210, Dallas, TX 75231 2018-06-20
1497246813 Stacy Jo Thomas Counselor 10260 N Central Expy Ste 280, Dallas, TX 75231 2018-05-21
1235626615 Texas Health Presbyterian Hospital Dallas Durable Medical Equipment & Medical Supplies 8160 Walnut Hill Lane, First Floor, Dallas, TX 75231 2018-04-20
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Taxonomy Information

Taxonomy Code 207XS0117X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Orthopaedic Surgery of the Spine

Taxonomy Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740812221 Granthem Pllc Orthopaedic Surgery 8440 Walnut Hill Ln Ste 230, Dallas, TX 75231-3816 2020-02-12
1265701650 Advanced Spine Center Orthopaedic Surgery 2430 Victory Park Ln, Ste 2001, Dallas, TX 75219-7709 2011-12-14
1457596561 Craig C Callewart Md Pa Orthopaedic Surgery 9101 N. Central Expwy., Suite 360, Dallas, TX 75231 2008-12-04
1922028638 William A Bruck Orthopaedic Surgery 9301 N Central Expy # 720-1982, Dallas, TX 75231-0806 2006-07-19
1053364547 John H Peloza Md Pa Orthopaedic Surgery 17980 Dallas Pkwy, Suite 300, Dallas, TX 75287 2006-05-18
1245283548 John H. Peloza Orthopaedic Surgery 17980 Dallas Parkway, Suite 300, Dallas, TX 75287 2006-05-18
1528051034 Stephen Ozanne Orthopaedic Surgery 3450 W Wheatland Rd, Suite 330, Dallas, TX 75237-3470 2005-08-30
1659378305 Venkat Sethuraman Orthopaedic Surgery 12200 Park Central Dr Ste 135, Dallas, TX 75251-2147 2005-07-07
1427054964 Kevin Gill Orthopaedic Surgery 5303 Harry Hines Blvd Fl 6, Suite 108, Dallas, TX 75390-8810 2005-06-21
1073135679 Txspi Pllc Orthopaedic Surgery 12200 Park Central Dr Ste 135, Dallas, TX 75251-2147 2020-05-18
Find all providers in DALLAS

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City DALLAS
Zip Code 75231

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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