Provider Demographics
NPI:1154826733
Name:FLORES-LOPEZ, CLAUDIA S (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:S
Last Name:FLORES-LOPEZ
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3157
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79923-3157
Mailing Address - Country:US
Mailing Address - Phone:915-577-0051
Mailing Address - Fax:915-577-0054
Practice Address - Street 1:4532 N MESA ST STE 2A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912
Practice Address - Country:US
Practice Address - Phone:915-544-0326
Practice Address - Fax:915-544-2897
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX790235363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX382749501Medicaid