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General NPI Number Information
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NPI Number | 1205137619
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Entity Type | Organization
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Legal Business Name | SWAPAN K BANERJEE MD PA
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 11/16/2010
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Provider Practice Location Address
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Address Line | 2622 NASA PKWY STE B
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City | SEABROOK
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State | TX
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Zip | 77586-3459
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Country | US
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Telephone | 281-326-6262
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Fax |
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Provider Business Mailing Address
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Address Line | 2622 NASA PKWY STE B
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City | SEABROOK
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State | TX
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Zip | 77586-3459
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Country | US
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Telephone | 281-326-6262
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SWAPAN K BANERJEE
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Credential | MD
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Telephone | 281-326-6262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | F8003
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License Number State | TX
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