Provider Demographics
NPI:1396514469
Name:FLORES-LEFRANC, DEREK ALEXANDER (LAC, CNMT)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:ALEXANDER
Last Name:FLORES-LEFRANC
Suffix:
Gender:M
Credentials:LAC, CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 CAMINO VAQUERO PKWY APT 2303
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-3305
Mailing Address - Country:US
Mailing Address - Phone:737-354-5262
Mailing Address - Fax:
Practice Address - Street 1:151 KIRKHAM CIR
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-9703
Practice Address - Country:US
Practice Address - Phone:254-307-7715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-29
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01927171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty