MEDICARE: SILVER OAKS HEALTH AND INDEPENDENCE MANAGEMENT INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1912247800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER OAKS HEALTH AND INDEPENDENCE MANAGEMENT INC.

Provider Business Mailing Address
First Line	:	3113 PERSHING DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79903-2524
Country	:	US
Telephone Number	:	956-307-9625
Fax Number	:

Provider Business Practice Location Address
First Line	:	3113 PERSHING DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79903-2524
Country	:	US
Telephone Number	:	956-307-9625
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HECTOR ALFONSO OLVERA
Credential	:	PH.D.
Telephone Number	:	915-328-9245

Provider Enumeration Date	:	02/28/2013
Last Update Date	:	02/28/2013

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