MEDICARE: ALMA NELY FLORES LPC-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	63234	TX
2	101YM0800X	Mental Health Counselor	63234	TX

General Provider Information

NPI Number	:	1104056118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALMA NELY FLORES LPC-S

Provider Business Mailing Address
First Line	:	11999 KATY FWY STE 230
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-1605
Country	:	US
Telephone Number	:	832-752-7004
Fax Number	:	281-336-0763

Provider Business Practice Location Address
First Line	:	11999 KATY FWY STE 230
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-1605
Country	:	US
Telephone Number	:	832-752-7004
Fax Number	:	281-336-0763

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2009
Last Update Date	:	12/09/2013

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