MEDICARE: NORA V FLORES CERT SURGICAL ASSIST

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	246ZC0007X	Surgical Assistant		TX
2	363AS0400X	Surgical Physician Assistant	PA02544	TX

General Provider Information

NPI Number	:	1225177041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORA V FLORES CERT SURGICAL ASSIST

Provider Business Mailing Address
First Line	:	6505 ELECTRA DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-7469
Country	:	US
Telephone Number	:	817-455-2064
Fax Number	:

Provider Business Practice Location Address
First Line	:	6505 ELECTRA DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-7469
Country	:	US
Telephone Number	:	817-455-2064
Fax Number	:

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	08/24/2019

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