Provider Demographics
NPI:1083800536
Name:FLORES, CARMEN LIRA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:LIRA
Last Name:FLORES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22369 PALOMA CELESTE CT
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-1913
Mailing Address - Country:US
Mailing Address - Phone:956-499-8682
Mailing Address - Fax:
Practice Address - Street 1:22369 PALOMA CELESTE CT
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-1913
Practice Address - Country:US
Practice Address - Phone:956-499-8682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6715103T00000X
TX25768103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool