Individual provider Active NPI

Jesus Rodolfo Flores, MS CCC-SLP

  • Speech-Language Pathologist
  • Los Fresnos, TX
National Provider Identifier
1861621047
Registry record updated Apr 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
18963 Issued in TX
Practice address
9475 Los Olmos
Los Fresnos, TX 78566-4588
Phone
(956) 455-5587
NPI assigned
Jul 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 18963 TX Primary

Addresses

Primary practice location

9475 Los Olmos
Los Fresnos, TX 78566-4588

Mailing address

9475 Los Olmos
Los Fresnos, TX 78566-4588
Phone (956) 455-5587

Other identifiers 1

IdentifierTypeStateIssuer
163606001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
18963TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Life Home Health, LLC - Healthcare Series Current Accepting new patients
Impact Life Home Health, LLC - Impact Life Rehab Series Current Accepting new patients
Impact Life Home Health, LLC - DME Series Current Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776556800000",
    "number": "1861621047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9475 LOS OLMOS",
            "city": "LOS FRESNOS",
            "state": "TX",
            "postal_code": "785664588",
            "telephone_number": "956-455-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9475 LOS OLMOS",
            "city": "LOS FRESNOS",
            "state": "TX",
            "postal_code": "785664588",
            "telephone_number": "956-455-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "JESUS",
        "middle_name": "RODOLFO",
        "name_prefix": "Mr.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-08",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "18963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163606001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Fresnos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.