Provider Demographics
NPI:1306126503
Name:FLORES, ANGEL (BSW, QMHP)
Entity type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:BSW, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 HIGHLAWN TER
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-7227
Mailing Address - Country:US
Mailing Address - Phone:512-569-0171
Mailing Address - Fax:
Practice Address - Street 1:8625 KING GEORGE DR
Practice Address - Street 2:BLDG A STE 111
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-2215
Practice Address - Country:US
Practice Address - Phone:214-631-7002
Practice Address - Fax:214-631-6698
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker