Provider Demographics
NPI:1285822304
Name:FLORES, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:CANALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2312 PALOS LOOP
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2100
Mailing Address - Country:US
Mailing Address - Phone:956-206-7993
Mailing Address - Fax:
Practice Address - Street 1:2335 E SAUNDERS ST
Practice Address - Street 2:SUITE 3
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5434
Practice Address - Country:US
Practice Address - Phone:956-791-4800
Practice Address - Fax:956-791-4422
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342022355S0801X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34202OtherSTATE LICENSE