Provider Demographics
NPI:1225415821
Name:FLORES, CRISTINA
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14951 BELLOWS FALLS LN
Mailing Address - Street 2:634
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-6103
Mailing Address - Country:US
Mailing Address - Phone:830-352-6596
Mailing Address - Fax:
Practice Address - Street 1:14951 BELLOWS FALLS LN
Practice Address - Street 2:634
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-6103
Practice Address - Country:US
Practice Address - Phone:830-352-6596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-03
Last Update Date:2015-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14864312343900000X, 347C00000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker