Provider Demographics
NPI:1841571452
Name:FLORES, BELINDA GORENA I
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:GORENA
Last Name:FLORES
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 S US HIGHWAY 281
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9696
Mailing Address - Country:US
Mailing Address - Phone:956-383-9333
Mailing Address - Fax:956-383-9334
Practice Address - Street 1:3121 S US HIGHWAY 281
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9696
Practice Address - Country:US
Practice Address - Phone:956-383-9333
Practice Address - Fax:956-383-9334
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210762503Medicaid
TX210762501Medicaid
TX210762502Medicaid
TX6322250001Medicare NSC