Provider Demographics
NPI:1780046904
Name:FLORES, GINA LYNN (AUD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:LYNN
Last Name:FLORES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 A 67TH STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-5004
Mailing Address - Country:US
Mailing Address - Phone:806-224-1755
Mailing Address - Fax:806-224-1674
Practice Address - Street 1:4702 67TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-5004
Practice Address - Country:US
Practice Address - Phone:806-224-1755
Practice Address - Fax:806-224-1674
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-26
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80680231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist