Healthcare Provider Details

I. General information

NPI: 1043128218
Provider Name (Legal Business Name): SAVANNAH SILVESTRY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W MELISSA RD APT 2011
MELISSA TX
75454-9894
US

IV. Provider business mailing address

230 W MELISSA RD APT 2011
MELISSA TX
75454-9894
US

V. Phone/Fax

Practice location:
  • Phone: 512-577-3951
  • Fax:
Mailing address:
  • Phone: 512-577-3951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20781
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: