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General NPI Number Information
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NPI Number | 1174981302
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Entity Type | Individual
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Provider Name | BRENO SATLERDEOLIVEIRADINIZ
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Gender | Male
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Dates
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Enumeration Date | 02/02/2016
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 1941 EAST RD
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City | HOUSTON
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State | TX
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Zip | 77054-6010
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Country | US
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Telephone | 713-486-2700
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Fax | 713-486-2721
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Provider Business Mailing Address
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Address Line | 3407 STILLWATER LN
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City | SUGAR LAND
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State | TX
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Zip | 77479-2206
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Country | US
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Telephone | 305-570-7053
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 45298
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License Number State | TX
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