Provider Demographics
NPI:1659909158
Name:BANERJEE, ORUNIMA
Entity Type:Individual
Prefix:
First Name:ORUNIMA
Middle Name:
Last Name:BANERJEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9123 CRESCENT CLOVER DR APT 2212
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8793
Mailing Address - Country:US
Mailing Address - Phone:205-394-3526
Mailing Address - Fax:
Practice Address - Street 1:20305 HOLZWARTH RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-5582
Practice Address - Country:US
Practice Address - Phone:205-394-3526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120861225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist