Provider Demographics
NPI:1881995637
Name:ROBERTO SILVA M.D PA
Entity type:Organization
Organization Name:ROBERTO SILVA M.D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-257-6011
Mailing Address - Street 1:102 PALO ALTO RD
Mailing Address - Street 2:SUITE 129
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-3758
Mailing Address - Country:US
Mailing Address - Phone:210-257-6011
Mailing Address - Fax:210-257-9478
Practice Address - Street 1:102 PALO ALTO RD
Practice Address - Street 2:SUITE 129
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3758
Practice Address - Country:US
Practice Address - Phone:210-257-6011
Practice Address - Fax:210-257-9478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3338174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100063001Medicaid
TX100063001Medicaid