Healthcare Provider Details

I. General information

NPI: 1376775197
Provider Name (Legal Business Name): KLENZ FLORES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2009
Last Update Date: 08/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4324 N MCCOLL RD
MCALLEN TX
78504-2477
US

IV. Provider business mailing address

4324 N MCCOLL RD
MCALLEN TX
78504-2477
US

V. Phone/Fax

Practice location:
  • Phone: 956-630-0240
  • Fax: 956-776-0126
Mailing address:
  • Phone: 956-630-0240
  • Fax: 956-776-0126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberL9264
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberK8264
License Number StateTX

VIII. Authorized Official

Name: SYLVIA HINOJOSA
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-630-0240