Provider Demographics
NPI:1821501347
Name:FLORES, DANIEL R (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:FLORES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 ADA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-1703
Mailing Address - Country:US
Mailing Address - Phone:210-358-5647
Mailing Address - Fax:210-358-5505
Practice Address - Street 1:1055 ADA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-1703
Practice Address - Country:US
Practice Address - Phone:210-358-5647
Practice Address - Fax:210-358-5505
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209741835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care