Provider Demographics
NPI:1174981302
Name:SATLERDEOLIVEIRADINIZ, BRENO
Entity type:Individual
Prefix:
First Name:BRENO
Middle Name:
Last Name:SATLERDEOLIVEIRADINIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BRENO
Other - Middle Name:SATLER DE OLIVEIRA
Other - Last Name:DINIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:3407 STILLWATER LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2206
Mailing Address - Country:US
Mailing Address - Phone:305-570-7053
Mailing Address - Fax:
Practice Address - Street 1:1941 EAST RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-6010
Practice Address - Country:US
Practice Address - Phone:713-486-2700
Practice Address - Fax:713-486-2721
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX452982084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry