Provider Demographics
NPI:1205853033
Name:D'SOUZA, DEMELZA A (CCC/A, F-AAA)
Entity type:Individual
Prefix:MS
First Name:DEMELZA
Middle Name:A
Last Name:D'SOUZA
Suffix:
Gender:F
Credentials:CCC/A, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10740 N GESSNER DR
Mailing Address - Street 2:STE 310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1240
Mailing Address - Country:US
Mailing Address - Phone:281-897-0416
Mailing Address - Fax:281-890-8908
Practice Address - Street 1:561 MEDICAL CENTER BLVD
Practice Address - Street 2:STE A
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4239
Practice Address - Country:US
Practice Address - Phone:281-338-1423
Practice Address - Fax:281-316-2173
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80038237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L12702Medicare PIN
TX8L12700Medicare PIN
TX8L12701Medicare PIN