MEDICARE: ACENETE 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	4886	TX

General Provider Information

NPI Number	:	1962180158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ACENETE FLORES

Provider Business Mailing Address
First Line	:	6800 PARK TEN BLVD STE 200S
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-4293
Country	:	US
Telephone Number	:	210-261-1060
Fax Number	:

Provider Business Practice Location Address
First Line	:	7137 W MILITARY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78227-2942
Country	:	US
Telephone Number	:	210-261-1799
Fax Number	:

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

Provider Enumeration Date	:	07/07/2023
Last Update Date	:	07/07/2023

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Directions to “ ACENETE FLORES ” Practice Location

Language	Start Address	Practice Location

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