Provider Demographics
NPI:1932617222
Name:SILVA, JANICE BUMAGAT
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:BUMAGAT
Last Name:SILVA
Suffix:
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 1:2407 CLIFFORD ST
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8519
Mailing Address - Country:US
Mailing Address - Phone:956-607-8416
Mailing Address - Fax:
Practice Address - Street 1:2407 CLIFFORD ST
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8519
Practice Address - Country:US
Practice Address - Phone:956-607-8416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-20
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136175363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX391963101Medicaid
TX749798OtherMEDICARE