Provider Demographics
NPI:1003314352
Name:FLORES-BAYER, TIMOTEO (OD)
Entity type:Individual
Prefix:
First Name:TIMOTEO
Middle Name:
Last Name:FLORES-BAYER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 KEMP BLVD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76309-3959
Mailing Address - Country:US
Mailing Address - Phone:940-723-2020
Mailing Address - Fax:940-723-6941
Practice Address - Street 1:1901 KEMP BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-3959
Practice Address - Country:US
Practice Address - Phone:940-723-2020
Practice Address - Fax:940-723-6941
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002631152W00000X
TX10162TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist