MEDICARE: MARIA CONSUELO FLORES

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1932837184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CONSUELO FLORES

Provider Business Mailing Address
First Line	:	PO BOX 3224
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78853-3224
Country	:	US
Telephone Number	:	830-968-7439
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 UNIVERSITY BLVD APT 316
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-8008
Country	:	US
Telephone Number	:	830-968-7439
Fax Number	:

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

Provider Enumeration Date	:	08/14/2022
Last Update Date	:	08/14/2022

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Directions to “ MARIA CONSUELO FLORES ” Practice Location

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