Provider Demographics
NPI:1679262448
Name:SILVA, ANDRES
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:SILVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2029
Mailing Address - Street 2:
Mailing Address - City:SAN ELIZARIO
Mailing Address - State:TX
Mailing Address - Zip Code:79849-2029
Mailing Address - Country:US
Mailing Address - Phone:915-540-6498
Mailing Address - Fax:
Practice Address - Street 1:13151 FRESNILLO
Practice Address - Street 2:
Practice Address - City:SAN ELIZARIO
Practice Address - State:TX
Practice Address - Zip Code:79849
Practice Address - Country:US
Practice Address - Phone:915-540-6498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119-009061225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist