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General NPI Number Information
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NPI Number | 1427292937
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Entity Type | Individual
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Provider Name | TATIANA SILVA SOUSA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/28/2009
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 5301 DAVIS LN STE 100
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City | AUSTIN
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State | TX
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Zip | 78749-4061
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Country | US
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Telephone | 512-615-2730
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Fax | 512-309-7024
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Provider Business Mailing Address
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Address Line | 5301 DAVIS LN STE 100
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City | AUSTIN
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State | TX
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Zip | 78749-4061
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Country | US
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Telephone | 512-615-2730
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Fax | 512-666-3764
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | P6922
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License Number State | TX
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