Provider Demographics
NPI:1255738514
Name:FLORES, AMY BETH
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BETH
Last Name:FLORES
Suffix:
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 1:7134 WASHITA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2339
Mailing Address - Country:US
Mailing Address - Phone:210-445-5564
Mailing Address - Fax:
Practice Address - Street 1:7134 WASHITA WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2339
Practice Address - Country:US
Practice Address - Phone:210-445-5564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist