Provider Demographics
NPI:1760747802
Name:FLORES, JOEY R (FNPC)
Entity Type:Individual
Prefix:
First Name:JOEY
Middle Name:R
Last Name:FLORES
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 W LAMPASAS ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-5644
Mailing Address - Country:US
Mailing Address - Phone:972-875-7799
Mailing Address - Fax:972-878-3031
Practice Address - Street 1:3124 W HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2435
Practice Address - Country:US
Practice Address - Phone:903-641-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-04
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX697885363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily