Provider Demographics
NPI:1275120610
Name:FLORES, ANASTACIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANASTACIA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12980 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4098
Mailing Address - Country:US
Mailing Address - Phone:210-372-0386
Mailing Address - Fax:
Practice Address - Street 1:12980 BANDERA RD
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4098
Practice Address - Country:US
Practice Address - Phone:210-372-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily