Provider Demographics
NPI:1760410732
Name:URUETA, SILVIA (NP)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:URUETA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 TRAILVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-6285
Mailing Address - Country:US
Mailing Address - Phone:214-571-6136
Mailing Address - Fax:214-237-9103
Practice Address - Street 1:809 SINGLETON BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212-4014
Practice Address - Country:US
Practice Address - Phone:214-571-6136
Practice Address - Fax:214-237-9103
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX527105363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX527105OtherSTATE LICENSE #
TX80N279OtherBLUE CROSS & BLUE SHIELD
TXR59704Medicare UPIN
TX86N319Medicare ID - Type Unspecified