Provider Demographics
NPI:1053176891
Name:FLORES SANTOS, NICOLE ANGELINE (DC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ANGELINE
Last Name:FLORES SANTOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19380 I-45 N
Mailing Address - Street 2:SUITE 170
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373
Mailing Address - Country:US
Mailing Address - Phone:281-719-0461
Mailing Address - Fax:281-362-5786
Practice Address - Street 1:20501 KATY FWY STE 230
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1943
Practice Address - Country:US
Practice Address - Phone:281-829-8587
Practice Address - Fax:281-362-5786
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor