Provider Demographics
NPI:1144438854
Name:D'SOUZA, PENNY LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:PENNY
Middle Name:LYNN
Last Name:D'SOUZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:PENNY
Other - Middle Name:LYNN
Other - Last Name:HIIPAKKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:308 HOLDERRIETH BLVD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375
Mailing Address - Country:US
Mailing Address - Phone:281-351-4911
Mailing Address - Fax:281-351-4915
Practice Address - Street 1:308 HOLDERRIETH BLVD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4536
Practice Address - Country:US
Practice Address - Phone:281-351-4911
Practice Address - Fax:281-351-4915
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015246207RC0000X
OH34.009992207RC0000X
TXN0833207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease