Provider Demographics
NPI:1639890650
Name:FLORES, VIMMI PATTNI
Entity Type:Individual
Prefix:
First Name:VIMMI
Middle Name:PATTNI
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 1:3711 ROCKLAND TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2803
Mailing Address - Country:US
Mailing Address - Phone:832-640-3988
Mailing Address - Fax:
Practice Address - Street 1:3711 ROCKLAND TERRACE LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2803
Practice Address - Country:US
Practice Address - Phone:832-640-3988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110233235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist