Provider Demographics
NPI:1982145876
Name:FLORES, KIMBERLY (ARNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SYDNEY BLVD
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:TX
Mailing Address - Zip Code:76577-5432
Mailing Address - Country:US
Mailing Address - Phone:512-898-4001
Mailing Address - Fax:
Practice Address - Street 1:200 SYDNEY BLVD
Practice Address - Street 2:
Practice Address - City:THORNDALE
Practice Address - State:TX
Practice Address - Zip Code:76577-5432
Practice Address - Country:US
Practice Address - Phone:512-898-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9294618363L00000X
CANP95006602363LP0200X
TX107941363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics