Provider Demographics
NPI:1790035947
Name:FLORES, JOE (NP)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N WATER ST
Mailing Address - Street 2:515
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78401-0299
Mailing Address - Country:US
Mailing Address - Phone:361-887-8670
Mailing Address - Fax:
Practice Address - Street 1:500 N WATER ST
Practice Address - Street 2:515
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-0299
Practice Address - Country:US
Practice Address - Phone:361-887-8670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX551280163WG0000X, 163WG0600X
TXAP108836363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WG0600XNursing Service ProvidersRegistered NurseGerontology