Provider Demographics
NPI:1811335045
Name:FLORES, NYDIA L (COTA)
Entity type:Individual
Prefix:MRS
First Name:NYDIA
Middle Name:L
Last Name:FLORES
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MS
Other - First Name:NYDIA
Other - Middle Name:L
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:12330 VANCE JACKSON RD APT 16105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-6042
Mailing Address - Country:US
Mailing Address - Phone:210-792-0955
Mailing Address - Fax:
Practice Address - Street 1:85 NE LOOP 410 STE 610
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5866
Practice Address - Country:US
Practice Address - Phone:800-437-7560
Practice Address - Fax:888-437-7561
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210252224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant