Provider Demographics
NPI:1851390736
Name:FLORES, AMADOR JR (OD)
Entity Type:Individual
Prefix:DR
First Name:AMADOR
Middle Name:
Last Name:FLORES
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2329 JACAMAN RD
Mailing Address - Street 2:STE 15
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6264
Mailing Address - Country:US
Mailing Address - Phone:956-753-7373
Mailing Address - Fax:956-753-7371
Practice Address - Street 1:6801 MCPHERSON AVE
Practice Address - Street 2:STE. 111
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6402
Practice Address - Country:US
Practice Address - Phone:956-753-7373
Practice Address - Fax:956-753-7371
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX5120TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019080302Medicaid
TX019080302Medicaid
TX8K5962Medicare PIN
TX6184490001Medicare NSC