Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP129011 | TX |
NPI | 1003299306 |
---|---|
Provider Name | Ms. Elissa Flores |
First Address | San Antonio, TX 78214-2876 |
Second Address | San Antonio, TX 78214-2876 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2015 |
Last Update Date | 10/07/2020 |