NPIMap

Individual provider Active NPI

Eloisa Yu Banez, MD

  • Internal Medicine Physician
  • Seymour, TX
National Provider Identifier
1699765974
Registry record updated Oct 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G0347 Issued in TX
Practice address
200 Stadium Drive
Seymour, TX 76380
Phone
(940) 889-5572
Fax
(940) 889-3337
NPI assigned
Oct 26, 2005
Last updated
Oct 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G0347 TX Primary

Addresses

Primary practice location

200 Stadium Drive
Seymour, TX 76380

Mailing address

201 Stadium Dr
Seymour, TX 76380
Phone (940) 889-5572

Other identifiers 4

IdentifierTypeStateIssuer
BA000H65LOtherTXBLUE CROSS
130795107MedicaidTX
110034454OtherTXRAILROAD MEDICARE PIN
130795102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090114000330 TX Practitioner - Internal Medicine 7517020787 Reassigns benefits to 1 organization
Practice locations: Seymour, TX

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor County Hospital DistrictGroup PAC ID 6103739222, 25 clinicians

Practice addresses (Care Compare)

200 Stadium Dr
Seymour, TX 76380-2344
Phone (940) 889-5572

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G0347TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor County Hospital District CurrentSince Jun 1, 2011 Accepting new patients
Baylor County Hospital District CurrentSince Jun 1, 2011 Accepting new patients
Hamilton County Hospital District Past Accepting new patients
Olney-Hamilton Hospital District Past Accepting new patients
Baylor County Hospital District Past Accepting new patients

Locations

200 Stadium Dr
Seymour, TX 76380
Phone (940) 888-5572

201 Stadium Dr
Seymour, TX 76380
Phone (940) 888-5583

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1699765974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 STADIUM DR",
            "city": "SEYMOUR",
            "state": "TX",
            "postal_code": "76380",
            "telephone_number": "940-889-5572",
            "fax_number": "940-889-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STADIUM DRIVE",
            "city": "SEYMOUR",
            "state": "TX",
            "postal_code": "76380",
            "telephone_number": "940-889-5572",
            "fax_number": "940-889-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANEZ",
        "first_name": "ELOISA",
        "middle_name": "YU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G0347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "BA000H65L",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130795107",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "110034454",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130795102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, TX

Sources for this page

Verify at the official NPI Registry.