Provider Demographics
NPI:1770753188
Name:FLORES EYE CARE CLINIC, PC
Entity type:Organization
Organization Name:FLORES EYE CARE CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-286-5410
Mailing Address - Street 1:2329 JACAMAN RD STE 15
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6264
Mailing Address - Country:US
Mailing Address - Phone:956-753-7373
Mailing Address - Fax:956-753-7371
Practice Address - Street 1:2329 JACAMAN RD STE 15
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6264
Practice Address - Country:US
Practice Address - Phone:956-753-7373
Practice Address - Fax:956-753-7371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194842401Medicaid
TX6184490001Medicare NSC
TX00Z019Medicare UPIN
TX00Z019Medicare PIN