Individual
SOUMO BANERJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
135 WATER ST, WEBSTER, TX 77598-5389
(281) 971-9711
Mailing address
1812 GRACE XING, FRIENDSWOOD, TX 77546-1534
(281) 971-9711
(281) 407-3632
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
Q8018
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
508324YWGE
PTAN
TX
Enumeration date
07/18/2008
Last updated
01/25/2024
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