Provider Demographics
NPI:1184156481
Name:FLORES, PRISCILLA (OTR)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 OLEANDER DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-6664
Mailing Address - Country:US
Mailing Address - Phone:956-878-5757
Mailing Address - Fax:
Practice Address - Street 1:2113 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78573-6664
Practice Address - Country:US
Practice Address - Phone:956-878-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118251225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist