DR. BANNIE LEE TABOR (M.D.) – Maternal & Fetal Medicine Physician, NPI 1992761274

DR. BANNIE LEE TABOR (M.D.) is a healthcare provider. based in Sunrise, Florida. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials M.D.. They hold a License No. G3834 (TX). The NPI Number for DR. BANNIE LEE TABOR (M.D.) is 1992761274

Main info

Male
44 Years Of Experience
Name
DR. BANNIE LEE TABOR (M.D.)
NPI
1992761274
Phone
(800) 243-3839
Address
1301 CONCORD TER
Enumeration Date
25 April 2006
Last Update Date
27 September 2011

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Secondary Phone
6822678694
Graduation Year
1982 (44 years ago)
PAC ID
9739085598
Group Practice PAC ID
2365342938
Professional Enrollment ID
I20050914000681
Address ID
TX761042133FT1325XAVEX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,164 OBSTETRICS/GYNECOLOGY in TX

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Provider Addresses for DR. BANNIE LEE TABOR (M.D.)

  • 1301, Concord Terrace, Sunrise, Broward County, Florida, 33323, United States

    SUNRISE, FL 333232843

    Phone: (800) 243-3839

    Type: Mailing

  • 1325, Pennsylvania Avenue, Fort Worth, Tarrant County, Texas, 76104, United States

    SUITE 600

    FORT WORTH, TX 761042158

    Phone: (817) 878-5298

    Fax: (817) 878-5289

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $55.

Total Amount is formed as General ($55) + Research ($0) + Ownership ($0) = $55.

Last reported payment date: 2023-08-10 • Largest payer in this snapshot: Innovation Technologies Inc ($37).

Total Amount

$55

General + Research + Ownership

Payments

2

Total payment records

General Amount

$55

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-09-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050914000681IObstetrics/GynecologyTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33323)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365342938View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YCA
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX

Reviews

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Frequently asked questions

Is there an official ID for DR. BANNIE LEE TABOR (M.D.) in U.S. healthcare records?
The official identifier for DR. BANNIE LEE TABOR (M.D.) is NPI 1992761274.
Active or inactive — what applies to DR. BANNIE LEE TABOR (M.D.)?
You should see DR. BANNIE LEE TABOR (M.D.) as active in CMS-hosted NPPES data.
What kind of doctor is DR. BANNIE LEE TABOR (M.D.)?
DR. BANNIE LEE TABOR (M.D.) is associated with Maternal & Fetal Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with DR. BANNIE LEE TABOR (M.D.)?
Directory geography for DR. BANNIE LEE TABOR (M.D.) centers on Sunrise, Florida.
When was this NPI issued?
Enumeration for DR. BANNIE LEE TABOR (M.D.) is noted as April 25, 2006 where the registry provides it.

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