Provider Demographics
NPI:1003299306
Name:FLORES, ELISSA (NP)
Entity Type:Individual
Prefix:MS
First Name:ELISSA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 SE MILITARY DR STE 117
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78214-2876
Mailing Address - Country:US
Mailing Address - Phone:210-924-8146
Mailing Address - Fax:210-675-9508
Practice Address - Street 1:1131 SE MILITARY DR STE 117
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-2876
Practice Address - Country:US
Practice Address - Phone:210-924-8146
Practice Address - Fax:210-675-9508
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-04
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129011363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily