Healthcare Provider Details

I. General information

NPI: 1821501347
Provider Name (Legal Business Name): DANIEL R. FLORES R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 ADA ST
SAN ANTONIO TX
78223-1703
US

IV. Provider business mailing address

1055 ADA ST
SAN ANTONIO TX
78223-1703
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-5647
  • Fax: 210-358-5505
Mailing address:
  • Phone: 210-358-5647
  • Fax: 210-358-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number20974
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: