Provider Demographics
NPI:1073123428
Name:FLORES, ALEXANDRA (RN IBCLC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2827 SILVER FALLS DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1997
Mailing Address - Country:US
Mailing Address - Phone:281-705-8659
Mailing Address - Fax:
Practice Address - Street 1:1621 LAKEVILLE DR STE 304
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2694
Practice Address - Country:US
Practice Address - Phone:281-305-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX754054163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty