Provider Demographics
NPI:1851743231
Name:FLORES, J.JAVIER (MD, CNIM)
Entity Type:Individual
Prefix:DR
First Name:J.JAVIER
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3711
Mailing Address - Country:US
Mailing Address - Phone:562-774-8316
Mailing Address - Fax:
Practice Address - Street 1:547 JOHNSON DR
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3711
Practice Address - Country:US
Practice Address - Phone:562-774-8316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3393246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic