Provider Demographics
NPI:1902369101
Name:BANERJI PLASTIC SURGERY
Entity Type:Organization
Organization Name:BANERJI PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOUMO
Authorized Official - Middle Name:
Authorized Official - Last Name:BANERJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-243-4769
Mailing Address - Street 1:1812 GRACE XING
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-1534
Mailing Address - Country:US
Mailing Address - Phone:281-971-9711
Mailing Address - Fax:281-407-3632
Practice Address - Street 1:135 WATER ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-5389
Practice Address - Country:US
Practice Address - Phone:281-971-9711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-13
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty