MEDICARE: DR. DIEGO BERNAL FLORES DDS

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	122300000X	Dentist	22344	TX

General Provider Information

NPI Number	:	1790823482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIEGO BERNAL FLORES DDS

Provider Business Mailing Address
First Line	:	3122 AMESBURY
Second Line	:
City	:	SUGARLAND
State	:	TX
Zip	:	77478
Country	:	US
Telephone Number	:	832-287-7952
Fax Number	:

Provider Business Practice Location Address
First Line	:	6804 HIGHWAY 6 SOUTH
Second Line	:	H
City	:	HOUSTON
State	:	TX
Zip	:	77083-3397
Country	:	US
Telephone Number	:	281-495-4100
Fax Number	:	281-988-6200

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/08/2007

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