Provider Demographics
NPI:1790249761
Name:FLORES, ROGELIO (FNP)
Entity Type:Individual
Prefix:
First Name:ROGELIO
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 W SAM HOUSTON BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5104
Mailing Address - Country:US
Mailing Address - Phone:956-758-1118
Mailing Address - Fax:956-758-1119
Practice Address - Street 1:1106 W SAM HOUSTON BLVD STE 1
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5104
Practice Address - Country:US
Practice Address - Phone:956-758-1118
Practice Address - Fax:956-758-1119
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-24
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty