Provider Demographics
NPI:1295347334
Name:FLORES, ABRAM JACOB (PT, DPT)
Entity type:Individual
Prefix:
First Name:ABRAM
Middle Name:JACOB
Last Name:FLORES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 FM 660
Mailing Address - Street 2:
Mailing Address - City:FERRIS
Mailing Address - State:TX
Mailing Address - Zip Code:75125-8780
Mailing Address - Country:US
Mailing Address - Phone:972-533-7038
Mailing Address - Fax:
Practice Address - Street 1:3454 ZAFARANO DR STE A
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2667
Practice Address - Country:US
Practice Address - Phone:505-216-5008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer