Provider Demographics
NPI:1679029524
Name:SILVA, HUMBERTO II
Entity Type:Individual
Prefix:
First Name:HUMBERTO
Middle Name:
Last Name:SILVA
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 SERRANIA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-2123
Mailing Address - Country:US
Mailing Address - Phone:915-253-7427
Mailing Address - Fax:915-527-7535
Practice Address - Street 1:4716 HONDO PASS DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-1421
Practice Address - Country:US
Practice Address - Phone:915-245-3580
Practice Address - Fax:915-245-3580
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4099183500000X
TX20824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist