Provider Demographics
NPI:1437259413
Name:FLORES, TANYA JEANICE (DC)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:JEANICE
Last Name:FLORES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3534 MISTIC GRV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3137
Mailing Address - Country:US
Mailing Address - Phone:210-264-7919
Mailing Address - Fax:
Practice Address - Street 1:4040 SW MILITARY DRIVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3521
Practice Address - Country:US
Practice Address - Phone:210-923-3861
Practice Address - Fax:210-923-8336
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10262111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor