Healthcare Provider Details

I. General information

NPI: 1194744763
Provider Name (Legal Business Name): FERNANDO E SILVA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/05/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17189 INTERSTATE 45 S STE 675
SHENANDOAH TX
77385-3320
US

IV. Provider business mailing address

17189 INTERSTATE 45 S STE 675
SHENANDOAH TX
77385-3320
US

V. Phone/Fax

Practice location:
  • Phone: 936-270-3905
  • Fax: 936-271-1584
Mailing address:
  • Phone: 936-270-3905
  • Fax: 936-271-1584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberM3737
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: