Provider Demographics
NPI:1326364936
Name:SILVA-RODRIGUEZ, THAIS B
Entity Type:Individual
Prefix:
First Name:THAIS
Middle Name:B
Last Name:SILVA-RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 TARANTO DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-7440
Mailing Address - Country:US
Mailing Address - Phone:347-413-0052
Mailing Address - Fax:
Practice Address - Street 1:8133 MESA DR STE 104
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-537-2293
Practice Address - Fax:877-635-0810
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist