Provider Demographics
NPI:1861720104
Name:MINUTA, SILVANA C (MED)
Entity type:Individual
Prefix:MS
First Name:SILVANA
Middle Name:C
Last Name:MINUTA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:SILVANA
Other - Middle Name:C
Other - Last Name:MINUTA-VIDAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED
Mailing Address - Street 1:34 GILMORE GROVE PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1635
Mailing Address - Country:US
Mailing Address - Phone:281-681-0200
Mailing Address - Fax:
Practice Address - Street 1:34 GILMORE GROVE PL
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1635
Practice Address - Country:US
Practice Address - Phone:281-681-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63955101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor