Provider Demographics
NPI:1124378435
Name:FLORES, STEPHANIE (CO)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 OAKMONT DR STE 1200
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1023
Mailing Address - Country:US
Mailing Address - Phone:512-255-4400
Mailing Address - Fax:512-255-4404
Practice Address - Street 1:2801 OAKMONT DR STE 1200
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1023
Practice Address - Country:US
Practice Address - Phone:512-255-4400
Practice Address - Fax:512-255-4404
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1520222Z00000X
TX1458390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program