Individual
DR. EDUARDO A. DE SOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1060 SW 4TH ST, MOORE, OK 73160-2494
(405) 302-2661
(405) 302-2670
Mailing address
1060 SW 4TH ST, MOORE, OK 73160-2494
(405) 302-2661
(405) 302-2670
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
27993
OK
2084N0400X
Neurology Physician
Primary
27993
OK
2084N0400X
Neurology Physician
MD421598
PA
2084N0600X
Clinical Neurophysiology Physician
27993
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111627
—
NJ
05
—
101714226
—
PA
Enumeration date
08/18/2006
Last updated
02/09/2021
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