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NPI Code Detail

MEDICARE: MR. ROGERIO LAZARO FLORES PTA

MEDICARE: MR. ROGERIO LAZARO FLORES PTA
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
1225200000XPhysical Therapy Assistant2051438TX

General Provider Information

NPI Number : 1730804063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROGERIO LAZARO FLORES PTA
Provider Business Mailing Address
First Line : 200 S IH 35
Second Line :
City : PEARSALL
State : TX
Zip : 78061-6601
Country : US
Telephone Number : 830-334-3617
Fax Number :
Provider Business Practice Location Address
First Line : 200 S IH 35
Second Line :
City : PEARSALL
State : TX
Zip : 78061-6601
Country : US
Telephone Number : 830-334-4152
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2022
Last Update Date : 10/10/2022

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