Provider Demographics
NPI:1720376361
Name:MOONFLOWER GROUP LLC
Entity Type:Organization
Organization Name:MOONFLOWER GROUP LLC
Other - Org Name:A PLUS AUDIOLOGY AND HEARING AID SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:AUD
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:FLORES
Authorized Official - Last Name:ROLDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-580-3277
Mailing Address - Street 1:2102 CRYSTAL DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7781
Mailing Address - Country:US
Mailing Address - Phone:956-580-3277
Mailing Address - Fax:956-580-3279
Practice Address - Street 1:1914 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3106
Practice Address - Country:US
Practice Address - Phone:956-580-3277
Practice Address - Fax:956-580-3279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-18
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51085231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty