Provider Demographics
NPI:1750969689
Name:RODRIGUES MOSTARDEIRO, THOMAZ (MD)
Entity type:Individual
Prefix:
First Name:THOMAZ
Middle Name:
Last Name:RODRIGUES MOSTARDEIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RUA PEDRO FUMAGALI 117, APARTAMENTO 501
Mailing Address - Street 2:
Mailing Address - City:CRUZ ALTA
Mailing Address - State:RS
Mailing Address - Zip Code:98040350
Mailing Address - Country:BR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5200 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7709
Practice Address - Country:US
Practice Address - Phone:214-542-8062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program