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1205848512
CHARLES JACK BANTA II
DALLAS, TX
NPI
1205848512
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine
(Licence: TX J0438)
Enumeration Date
2006-08-13
Last Update Date
2007-07-08
Business Address
-- CHARLES JACK BANTA II MD
8220 WALNUT HILL LN STE 608
DALLAS, TX 75231-4424
Phone number: 214-987-3434
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Mailing Address
-- CHARLES JACK BANTA II MD
8220 WALNUT HILL LN STE 608
DALLAS, TX 75231-4424
Phone number: 214-987-3434
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