Provider Demographics
NPI:1073086229
Name:DA SILVA, ROBERT (APRN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:DA SILVA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 RIVER POINTE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2817
Mailing Address - Country:US
Mailing Address - Phone:936-756-2555
Mailing Address - Fax:936-756-2534
Practice Address - Street 1:200 RIVER POINTE DR STE 120
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2817
Practice Address - Country:US
Practice Address - Phone:936-756-2555
Practice Address - Fax:936-756-2534
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily