Provider Demographics
NPI:1891141438
Name:SILVA GARCES, VIVIAN MARGARITA I
Entity Type:Individual
Prefix:MISS
First Name:VIVIAN
Middle Name:MARGARITA
Last Name:SILVA GARCES
Suffix:I
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 1:3603 SOUTHRIDGE DR
Mailing Address - Street 2:APTO 2031
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7739
Mailing Address - Country:US
Mailing Address - Phone:786-389-6319
Mailing Address - Fax:
Practice Address - Street 1:3603 SOUTHRIDGE DR
Practice Address - Street 2:APTO 2031
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7739
Practice Address - Country:US
Practice Address - Phone:786-389-6319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16-246246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX711147740Medicaid