Provider Demographics
NPI:1609143361
Name:SILVA, GERALD JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:JOSEPH
Last Name:SILVA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10609 CORALSTONE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1710
Mailing Address - Country:US
Mailing Address - Phone:915-592-5298
Mailing Address - Fax:
Practice Address - Street 1:11685 MONTWOOD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-0722
Practice Address - Country:US
Practice Address - Phone:915-855-7704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist