Healthcare Provider Details

I. General information

NPI: 1265366280
Provider Name (Legal Business Name): OSCAR SILVA MS, LAT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 UNIVERSITY ST
PELLA IA
50219-1999
US

IV. Provider business mailing address

744 SE 27TH ST
DES MOINES IA
50317-1206
US

V. Phone/Fax

Practice location:
  • Phone: 641-628-5451
  • Fax:
Mailing address:
  • Phone: 515-745-7463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number139362
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: