DR. SERGIO EDUARDO SOUZA (NPI# 1558305979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558305979 |
| Entity Type | Individual |
| Full Name | DR. SERGIO EDUARDO SOUZA |
| Credential | M.D |
| Practice Address |
3551 Roger Brooke Dr Fort Sam Houston TX 78234-4504 |
| Practice Telephone | 2199162888 |
| Mailing Telephone | 2199162888 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2013-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 0101238938 | VA | Allopathic & Osteopathic Physicians |
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
35090134 | OH | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
M5517 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS/BLUE SHIELD | 8CZ439 | 01 |
| TX | PENDING | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952778532 | Sergio Gomes De Souza | Dentist | 5115 N Dysart Rd, Litchfield Park, AZ 85340-3032 | 2015-08-30 |
| Street Address |
3551 ROGER BROOKE DR |
| City | FORT SAM HOUSTON |
| State | TX |
| Zip Code | 78234-4504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093338 | Aneesh N/a Benoy | Nurse Practitioner | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-11-02 |
| 1164021580 | William Edward Vick | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-19 |
| 1548868003 | Julia D Coffey | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-15 |
| 1801493465 | Emiri Elliott | Registered Nurse | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-07 |
| 1437756574 | Clarence Michael Sullivan | Military Health Care Provider | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-01 |
| 1093320350 | Natalie Marie Greene | Physical Therapist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-09-14 |
| 1033722509 | Kody Vallejo | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-08-25 |
| 1558972620 | Renee Therese Hart | Nurse Practitioner | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-08-12 |
| 1235749722 | Emily Ann Robinson | Nurse Practitioner | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-08-09 |
| 1902415367 | Hannah Daniel | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942884 | Thomas Ballas | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa-fort Sam Houston, Department of Behavioral Medicine-mche-dbm, San Antonio, TX 78234 | 2020-08-17 |
| 1124657366 | Wendy Harris | Pharmacist | 3041 Garden Ave, Fort Sam Houston, TX 78234 | 2020-04-08 |
| 1215564729 | Travis Frantz | Student in an Organized Health Care Education/Training Program | 3551 Rodger Brooke Drive, Jbsa Fort Sam Houston, TX 78234 | 2020-03-25 |
| 1508492695 | Matthew Grossmann | Student in an Organized Health Care Education/Training Program | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234 | 2020-03-20 |
| 1235793407 | Jessica Maria May Franklin | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa Fort Sam Houston, San Antonio, TX 78234 | 2019-04-23 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1053805515 | Rene Espinosa | Social Worker | San Antonio Medical Center, 3551 Roger Brooke Dr, Jbsa, TX 78234 | 2018-06-19 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| 1063909158 | Benjamin Walker Appelo | General Practice | San Antonio Mil Med Center 3551 Roger Brooke Dr, Mche-zdm-m, San Antonio, TX 78234 | 2018-04-16 |
| Find all providers in zip 78234 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356958086 | Universal Health Solutions LLC | Pain Medicine | 15223 Park Estates Ln, Houston, TX 77062-3657 | 2020-09-27 |
| 1366065997 | Siai, Pllc | Pain Medicine | 149 E State Highway 121, Suite 105, Coppell, TX 75019 | 2020-05-18 |
| 1316568512 | Pain Management Physicians of Dallas, Pllc | Pain Medicine | 4560 Lake Ridge Pkwy Ste 300, Grand Prairie, TX 75052-1706 | 2020-04-29 |
| 1376172304 | Am/pm Medical Centers | Pain Medicine | 800 W Airport Fwy # 625, Irving, TX 75062-6312 | 2020-04-02 |
| 1326672866 | Arthritis Relief Institute | Pain Medicine | 12606 Greenville Ave Ste 195, Dallas, TX 75243-1909 | 2020-02-24 |
| 1215568035 | Casey Jones LLC | Pain Medicine | 21300 Provincial Blvd Ste 200, Katy, TX 77450-7580 | 2020-01-30 |
| 1801435896 | Comprehensive Pain Institute Pllc | Pain Medicine | 1305 Airport Fwy Ste 302b, Bedford, TX 76021-6604 | 2019-12-23 |
| 1497301386 | Skilled Pain Care Clinic, P.a. | Pain Medicine | 2840 Commercial Center Blvd Ste 104, Katy, TX 77494-6412 | 2019-08-15 |
| 1154976025 | Stephen M. Sims, Md, Pa | Pain Medicine | 17189 I 45 S Ste 265, Shenandoah, TX 77385-3323 | 2019-08-07 |
| 1104479146 | Shaw Pain Clinic Pllc | Pain Medicine | 503 Fm 1431 East, Suite 201, Marble Falls, TX 78654-5252 | 2019-07-18 |
| Find all providers with the same taxonomy | ||||
| City | FORT SAM HOUSTON |
| Zip Code | 78234 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.