Provider Demographics
NPI:1770873283
Name:FLORES, CHELSIE LEE (DC)
Entity type:Individual
Prefix:
First Name:CHELSIE
Middle Name:LEE
Last Name:FLORES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CHELSIE
Other - Middle Name:LEE
Other - Last Name:FETTIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:403 STATE HIGHWAY 110 N
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-3109
Mailing Address - Country:US
Mailing Address - Phone:903-839-1000
Mailing Address - Fax:903-839-4000
Practice Address - Street 1:403 STATE HIGHWAY 110 N
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-3109
Practice Address - Country:US
Practice Address - Phone:903-839-1000
Practice Address - Fax:903-839-4000
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCF1132179OtherAMERICAN SPECIALTY HEALTH-CIGNA
TX1881972727OtherBCBS
TX8V0494OtherBCBS
TX3470262-01Medicaid
TXTXB132906Medicare PIN