Provider Demographics
NPI:1669472577
Name:SILVA, MARCO T (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:T
Last Name:SILVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-606-6400
Mailing Address - Fax:903-606-1522
Practice Address - Street 1:2965 HARRISON ST
Practice Address - Street 2:SUITE 111
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1100
Practice Address - Country:US
Practice Address - Phone:409-898-7800
Practice Address - Fax:409-898-3295
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7561207T00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8813744001OtherCIGNA
TX148913001Medicaid
TX7333499OtherAETNA
TX0089KHOtherBCBS
TXA002OtherTRICARE CHAMPUS
TXP00142069OtherRAILROAD MEDICARE
TX0020HDOtherGROUP BCBS
TX1646150Medicaid
TX8B2245Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE
TX0089KHOtherBCBS
TX148913001Medicaid