Provider Demographics
NPI:1679241954
Name:FLORES, RICARDO (DC)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 RANCH ROAD 620 S STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-5632
Mailing Address - Country:US
Mailing Address - Phone:737-279-8600
Mailing Address - Fax:737-279-8601
Practice Address - Street 1:1008 RANCH ROAD 620 S STE 100
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-5632
Practice Address - Country:US
Practice Address - Phone:737-279-8600
Practice Address - Fax:737-279-8601
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor