Provider Demographics
NPI:1427108786
Name:TEIXEIRA-DA-SILVA, JOSE C JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:C
Last Name:TEIXEIRA-DA-SILVA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CARLOS
Other - Middle Name:
Other - Last Name:DASILVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:47 OBERY ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2230
Mailing Address - Country:US
Mailing Address - Phone:508-747-4883
Mailing Address - Fax:508-747-6661
Practice Address - Street 1:47 OBERY ST STE 1A
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2230
Practice Address - Country:US
Practice Address - Phone:508-747-4883
Practice Address - Fax:087-476-6615
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81850207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110057582AMedicaid
MA3156761Medicaid