Individual provider Active NPI

Ildefonzo Flores, M.D.

  • Internal Medicine Physician
  • Laredo, TX
National Provider Identifier
1205867595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G8837 Issued in TX
Practice address
1520 E San Pedro Dr
Suite 101
Laredo, TX 78041
Phone
(956) 724-1698
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G8837 TX Primary

Addresses

Primary practice location

1520 E San Pedro Dr
Suite 101
Laredo, TX 78041

Mailing address

PO Box 440843
Laredo, TX 78044-0843
Phone (956) 724-1698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080428000345 TX Practitioner - Internal Medicine 4385722669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1520 E San Pedro
Suite 101
Laredo, TX 78041-5354
Phone (956) 724-1698

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G8837TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ildefonzo Flores MD PA Internal Medicine CurrentSince Nov 1, 2007 Accepting new patients

Locations

1520 E San Pedro St
Ste 101
Laredo, TX 78041
Phone (956) 724-1698

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205867595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440843",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780440843",
            "telephone_number": "956-724-1698",
            "fax_number": "972-772-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 E SAN PEDRO DR",
            "address_2": "SUITE 101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78041",
            "telephone_number": "956-724-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "ILDEFONZO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G8837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.