Souza, Sergio Eduardo

Souza, Sergio Eduardo is an individual health care provider with primary practice located at 3551 Roger Brooke Dr , Fort Sam Houston TX 78234-4504. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Souza, Sergio Eduardo can be contacted via phone (219) 916-2888.

Contact Information

Primary practice address
3551 Roger Brooke Dr Fort Sam Houston TX 78234-4504
Phone: (219) 916-2888
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 0101238938 Virginia
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 35090134 Ohio
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X M5517 Texas

Profile Details

NPI number 1558305979
LBN Legal business name Souza, Sergio Eduardo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Dec 5th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558305979 NPPES
Texas Other 8CZ439 BLUE CROSS/BLUE SHIELD
Texas MEDICAID PENDING BLUE CROSS/BLUE SHIELD

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