Provider Demographics
NPI:1245101583
Name:FLORES, LUIS JOSHUA (PA-C)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:JOSHUA
Last Name:FLORES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 WESTLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5722
Mailing Address - Country:US
Mailing Address - Phone:830-513-3410
Mailing Address - Fax:
Practice Address - Street 1:830 KOHLERS XING STE 100
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2473
Practice Address - Country:US
Practice Address - Phone:512-268-2613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty