Provider Demographics
NPI:1902927932
Name:FLORES, MARIA ELENA (PA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:FLORES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 SAVANNAH AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-3006
Mailing Address - Country:US
Mailing Address - Phone:956-631-5995
Mailing Address - Fax:956-631-1372
Practice Address - Street 1:721 SAVANNAH AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-3006
Practice Address - Country:US
Practice Address - Phone:956-631-5995
Practice Address - Fax:956-631-1372
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02565363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD66965Medicare UPIN