Healthcare Provider Details

I. General information

NPI: 1043005341
Provider Name (Legal Business Name): DYLAN FLORES LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 N LOOP 288 STE 123
DENTON TX
76209-4218
US

IV. Provider business mailing address

306 N LOOP 288 STE 123
DENTON TX
76209-4218
US

V. Phone/Fax

Practice location:
  • Phone: 940-553-0012
  • Fax:
Mailing address:
  • Phone: 940-553-0012
  • Fax: 469-613-0883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number114987
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: