Provider Demographics
NPI:1689634883
Name:SILVA, JAIME LUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:LUIS
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 1:100 UPTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7559
Mailing Address - Country:US
Mailing Address - Phone:956-546-5500
Mailing Address - Fax:956-546-2035
Practice Address - Street 1:100 UPTOWN AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7559
Practice Address - Country:US
Practice Address - Phone:956-546-5500
Practice Address - Fax:956-546-2035
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5015207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00U55Y0Medicaid
TXP00U55Y0Medicaid
TX00U55YMedicare ID - Type Unspecified