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Contact Information

ETHAN S BANNAR, PSYD
271 FT RICHARDSON AVE
GOODFELLOW AFB, TX76908
 Phone: 325-654-3122
 Fax: 325-654-5161
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Counselor

101Y00000X
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for ETHAN S BANNAR · (Male)

NPI # 1467962928
Status Active
Credentials PSYD (Doctor of Psychology)
Entity Individual
Enumeration date 10/10/2017
Last updated 07/13/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0810007978
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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