MEDICARE: RENEE SHALETTE RODRIGUES-D'SOUZA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0006X	Developmental - Behavioral Pediatrics Physician	35.085921	OH

General Provider Information

NPI Number	:	1467660134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE SHALETTE RODRIGUES-D'SOUZA M.D.

Provider Business Mailing Address
First Line	:	2 GREENWAY PLZ STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77046-0207
Country	:	US
Telephone Number	:	832-828-3660
Fax Number	:	832-828-3660

Provider Business Practice Location Address
First Line	:	8080 N STADIUM DR
Second Line	:	SUITE 180
City	:	HOUSTON
State	:	TX
Zip	:	77054-1829
Country	:	US
Telephone Number	:	832-822-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	03/08/2016

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