Basic Information
Provider Information
NPI: 1932696333
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: D'SILVA
FirstName: NERISSA
MiddleName: CHRISTINE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 UNIVERSITY BLVD
Address2:  
City: GALVESTON
State: TX
PostalCode: 775550550
CountryCode: US
TelephoneNumber: 4097720099
FaxNumber: 4097477012
Practice Location
Address1: 301 UNIVERSITY BLVD
Address2:  
City: GALVESTON
State: TX
PostalCode: 775550001
CountryCode: US
TelephoneNumber: 4097720099
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/20/2018
LastUpdateDate: 06/28/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/28/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207K00000XBP10074372TXN Allopathic & Osteopathic PhysiciansAllergy & Immunology 
207R00000X11393202-1205UTY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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