Provider Demographics
NPI:1649230400
Name:FLORES, CATHERINE BARRETT (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:BARRETT
Last Name:FLORES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E MAIN ST
Mailing Address - Street 2:BLDG. B
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
Practice Address - Street 2:BLDG. B
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
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18858208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOTHOOOMedicare UPIN