Provider Demographics
NPI:1114281292
Name:SILVA, FELIPE JR
Entity Type:Individual
Prefix:
First Name:FELIPE
Middle Name:
Last Name:SILVA
Suffix:JR
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 1:30726 FM 2520
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-7141
Mailing Address - Country:US
Mailing Address - Phone:956-241-0893
Mailing Address - Fax:
Practice Address - Street 1:30726 FM 2520
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-7141
Practice Address - Country:US
Practice Address - Phone:956-241-0893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist