Provider Demographics
NPI:1346049418
Name:MEDINA-FLORES, BRENDA LISBETH (MS,)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LISBETH
Last Name:MEDINA-FLORES
Suffix:
Gender:
Credentials:MS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 FM 3133
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-6208
Mailing Address - Country:US
Mailing Address - Phone:469-502-1313
Mailing Address - Fax:
Practice Address - Street 1:1515 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3256
Practice Address - Country:US
Practice Address - Phone:469-966-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204057106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist