Healthcare Provider Details

I. General information

NPI: 1275426629
Provider Name (Legal Business Name): LINDA FLORES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 SURETY DR STE 100
EL PASO TX
79905-2033
US

IV. Provider business mailing address

6060 SURETY DR STE 100
EL PASO TX
79905-2033
US

V. Phone/Fax

Practice location:
  • Phone: 915-262-6192
  • Fax: 833-526-6362
Mailing address:
  • Phone: 915-262-6192
  • Fax: 833-526-6362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT90215
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: