1659800688 NPI number — IRENE YVONNE SILVENRAIL RN L.AC

Table of content: IRENE YVONNE SILVENRAIL RN L.AC (NPI 1659800688)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659800688 NPI number — IRENE YVONNE SILVENRAIL RN L.AC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILVENRAIL
Provider First Name:
IRENE
Provider Middle Name:
YVONNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN L.AC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FALK
Provider Other First Name:
IRENE
Provider Other Middle Name:
YVONNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN ACUPUNCTURIST
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659800688
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20222 GRAIL QUEST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78258-3318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-792-7414
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17890 BLANCO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78232-1039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-792-7414
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  TEMP , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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