Provider Demographics
NPI:1245260728
Name:FLORES, SANDRA (WHNP)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 CORPUS CHRISTI ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5261
Mailing Address - Country:US
Mailing Address - Phone:956-727-0722
Mailing Address - Fax:956-727-0498
Practice Address - Street 1:801 CORPUS CHRISTI ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-5261
Practice Address - Country:US
Practice Address - Phone:956-727-0722
Practice Address - Fax:956-727-0498
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX627306363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159713001Medicaid
TX159713001Medicaid
TX849143Medicare PIN