Provider Demographics
NPI:1619144367
Name:SILVERS, CONNIE C
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:C
Last Name:SILVERS
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 1:830 ESSEX DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-8450
Mailing Address - Country:US
Mailing Address - Phone:972-347-3973
Mailing Address - Fax:972-347-3973
Practice Address - Street 1:830 ESSEX DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-8450
Practice Address - Country:US
Practice Address - Phone:972-347-3973
Practice Address - Fax:972-347-3973
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist