Provider Demographics
NPI:1790823482
Name:FLORES, DIEGO BERNAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:BERNAL
Last Name:FLORES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3122 AMESBURY
Mailing Address - Street 2:
Mailing Address - City:SUGARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:832-287-7952
Mailing Address - Fax:
Practice Address - Street 1:6804 HIGHWAY 6 SOUTH
Practice Address - Street 2:H
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-3397
Practice Address - Country:US
Practice Address - Phone:281-495-4100
Practice Address - Fax:281-988-6200
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22344122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist