Provider Demographics
NPI:1447337092
Name:SILVA, BRENDA D (PA-C)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:D
Last Name:SILVA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 EL PASO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2819
Mailing Address - Country:US
Mailing Address - Phone:915-774-2550
Mailing Address - Fax:915-774-2551
Practice Address - Street 1:5160 EL PASO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2819
Practice Address - Country:US
Practice Address - Phone:915-774-2550
Practice Address - Fax:915-774-2551
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04611363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX408400YLPSOtherWELLMED PTAN
TX130880104Medicaid
TX347393601Medicaid
TXQ67763Medicare UPIN