Provider Demographics
NPI:1164788311
Name:VILLALOBOS- SILVA, ENRIQUE (MD)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:VILLALOBOS- SILVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-6602
Mailing Address - Country:US
Mailing Address - Phone:915-319-6672
Mailing Address - Fax:
Practice Address - Street 1:3660 JOE BATTLE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-0007
Practice Address - Country:US
Practice Address - Phone:915-219-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3612207P00000X, 208VP0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program