Provider Demographics
NPI:1568167880
Name:DIEUDONNE, IZONDERERA
Entity Type:Individual
Prefix:
First Name:IZONDERERA
Middle Name:
Last Name:DIEUDONNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7231 MELROSE LN
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-4457
Mailing Address - Country:US
Mailing Address - Phone:832-762-9095
Mailing Address - Fax:
Practice Address - Street 1:7231 MELROSE LN
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-4457
Practice Address - Country:US
Practice Address - Phone:832-762-9095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278P4000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPatient Transport