Provider Demographics
NPI:1356380885
Name:FLORES, JORGE H (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:H
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2835
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78551-2835
Mailing Address - Country:US
Mailing Address - Phone:956-412-1125
Mailing Address - Fax:956-440-8854
Practice Address - Street 1:4402 E SESAME DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-9290
Practice Address - Country:US
Practice Address - Phone:956-412-1125
Practice Address - Fax:956-440-8854
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7734207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P5561OtherBLUE CROSS BLUE SHIELD
TX143837603Medicaid
TX8P5561OtherBLUE CROSS BLUE SHIELD
TX143837603Medicaid