Provider Demographics
NPI:1073619029
Name:BANERJEE, SWAPAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:SWAPAN
Middle Name:K
Last Name:BANERJEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2622 NASA PKWY
Mailing Address - Street 2:STE B
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-3459
Mailing Address - Country:US
Mailing Address - Phone:281-326-6262
Mailing Address - Fax:281-532-4200
Practice Address - Street 1:2622 NASA PKWY
Practice Address - Street 2:STE B
Practice Address - City:SEABROOK
Practice Address - State:TX
Practice Address - Zip Code:77586-3459
Practice Address - Country:US
Practice Address - Phone:281-326-6262
Practice Address - Fax:281-532-4200
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2010-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF8003207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115780201Medicaid
TXB21078Medicare UPIN