Provider Demographics
NPI:1487181673
Name:SILVA, STEPHEN GARRETT (CTP, CFO)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:GARRETT
Last Name:SILVA
Suffix:
Gender:M
Credentials:CTP, CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8407 E 81ST ST APT 227
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-8029
Mailing Address - Country:US
Mailing Address - Phone:713-857-8262
Mailing Address - Fax:
Practice Address - Street 1:6052 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9212
Practice Address - Country:US
Practice Address - Phone:918-488-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-18
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
03819OtherABC