Provider Demographics
NPI:1356645683
Name:SILVA, AMY (OTR, RD/LD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SILVA
Suffix:
Gender:F
Credentials:OTR, RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10714 PROVIDENCE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3366
Mailing Address - Country:US
Mailing Address - Phone:956-793-8892
Mailing Address - Fax:
Practice Address - Street 1:807 N CAGE BLVD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577
Practice Address - Country:US
Practice Address - Phone:956-283-1889
Practice Address - Fax:956-283-7014
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81799133V00000X
TX118485225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX16893447OtherTX DL