=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215347695
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERTO FLORES MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2014
-----------------------------------------------------
Last Update Date | 02/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 124 W CASTELLANO DR STE 105
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79912-6153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-259-8509
-----------------------------------------------------
Fax | 915-259-8657
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 124 W CASTELLANO DR STE 105
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79912-6153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-259-8509
-----------------------------------------------------
Fax | 915-259-8657
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | T9682
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------