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General NPI Number Information
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NPI Number | 1124095799
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Entity Type | Individual
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Provider Name | RAHUL BANERJEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 01/24/2021
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Provider Practice Location Address
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Address Line | 4090 MAPLESHADE LN STE 100
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City | PLANO
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State | TX
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Zip | 75093-0025
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Country | US
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Telephone | 888-624-6882
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Fax | 888-882-4498
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Provider Business Mailing Address
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Address Line | 4090 MAPLESHADE LN STE 100
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City | PLANO
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State | TX
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Zip | 75093-0025
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Country | US
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Telephone | 888-624-6882
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Fax | 888-882-4498
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | M1491
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | M1491
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License Number State | TX
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