Healthcare Provider Details

I. General information

NPI: 1497467492
Provider Name (Legal Business Name): LUISA FLOREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 AVENUE J
LUBBOCK TX
79411-2121
US

IV. Provider business mailing address

2002 AVENUE J
LUBBOCK TX
79411-2121
US

V. Phone/Fax

Practice location:
  • Phone: 806-730-8700
  • Fax:
Mailing address:
  • Phone: 806-730-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License NumberN1635
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: