Healthcare Provider Details

I. General information

NPI: 1194693747
Provider Name (Legal Business Name): SILVERIO DANIEL BARELA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 KINLEY AVE NE
ALBUQUERQUE NM
87102-1516
US

IV. Provider business mailing address

24 SILVER LN
ESTANCIA NM
87016-6743
US

V. Phone/Fax

Practice location:
  • Phone: 505-225-2177
  • Fax: 505-225-2177
Mailing address:
  • Phone: 505-414-1381
  • Fax: 505-414-1381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number00023951
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: