Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 8503 | TX |
NPI | 1003844218 |
---|---|
Provider Name | Dr. Alex Flores |
First Address | Edinburg, TX 78539-9168 |
Second Address | Edinburg, TX 78539-9168 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V05959 | (02) | TX |