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General NPI Number Information
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NPI Number | 1811594443
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Entity Type | Individual
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Provider Name | LEYNAH FLORES
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Gender | Female
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Dates
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Enumeration Date | 10/06/2020
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 1333 W WASHINGTON ST
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City | STEPHENVILLE
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State | TX
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Zip | 76401-4168
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Country | US
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Telephone | 254-968-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 211 W VALVERDE ST
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City | CRYSTAL CITY
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State | TX
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Zip | 78839-2820
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Country | US
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Telephone | 830-854-7445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT8876
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License Number State | TX
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