Healthcare Provider Details
I. General information
NPI: 1982935185
Provider Name (Legal Business Name): DR. JOE ANGEL SILVA JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/27/2010
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1405 S DOUGLAS BLVD STE E
MIDWEST CITY OK
73130-5240
US
IV. Provider business mailing address
350 LAS COLINAS BLVD E APT 4084
IRVING TX
75039-5823
US
V. Phone/Fax
- Phone: 405-455-5778
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 11234 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: