MEDICARE: VANESSA FLORES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	39244	TX

General Provider Information

NPI Number	:	1548749930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA FLORES

Provider Business Mailing Address
First Line	:	PO BOX 337
Second Line	:
City	:	BENAVIDES
State	:	TX
Zip	:	78341-0337
Country	:	US
Telephone Number	:	361-227-9007
Fax Number	:

Provider Business Practice Location Address
First Line	:	9955 BUFFALO SPEEDWAY APT 17308
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1358
Country	:	US
Telephone Number	:	361-227-9007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	08/07/2018

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Directions to “ VANESSA FLORES ” Practice Location

Language	Start Address	Practice Location

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