Provider Demographics
NPI:1245386697
Name:FLORES PEDIATRICS, LLC
Entity Type:Organization
Organization Name:FLORES PEDIATRICS, LLC
Other - Org Name:FLORES PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:BARRETT
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-350-3000
Mailing Address - Street 1:415 E MAIN ST BLDG B
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-2259
Mailing Address - Country:US
Mailing Address - Phone:405-350-3000
Mailing Address - Fax:405-350-8017
Practice Address - Street 1:415 E MAIN ST BLDG B
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-2259
Practice Address - Country:US
Practice Address - Phone:405-350-3000
Practice Address - Fax:405-350-8017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18858208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1649230400OtherNPI FOR CATHERINE FLORES
OK19454OtherMEDICAL LICEN JAVIER FLOR
OK18858OtherMEDICAL LIC CATHERINE FLO
OK1922069269OtherNPI FOR JAVIER FLORES MD
OKG45633Medicare UPIN
OK18858OtherMEDICAL LIC CATHERINE FLO