Provider Demographics
NPI:1124320262
Name:SILVA, CHAVEL THOMAS (LSA)
Entity type:Individual
Prefix:
First Name:CHAVEL
Middle Name:THOMAS
Last Name:SILVA
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20700 US HIGHWAY 281 N, #108-439
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7655
Mailing Address - Country:US
Mailing Address - Phone:210-802-4662
Mailing Address - Fax:
Practice Address - Street 1:3619 PAESANOS PKWY STE 302
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1259
Practice Address - Country:US
Practice Address - Phone:210-802-4662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00464246ZC0007X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00464OtherLSA LICENSE
TX12681741OtherCAQH
TX12681741OtherCAQH
TX81NN04OtherBCBSTX