Provider Demographics
NPI:1770088833
Name:ABEYTA-FLORES, MEGAN ERIN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ERIN
Last Name:ABEYTA-FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:HYDRO
Mailing Address - State:OK
Mailing Address - Zip Code:73048-8924
Mailing Address - Country:US
Mailing Address - Phone:208-503-9705
Mailing Address - Fax:
Practice Address - Street 1:505 9TH STREET CIR
Practice Address - Street 2:
Practice Address - City:HYDRO
Practice Address - State:OK
Practice Address - Zip Code:73048-8435
Practice Address - Country:US
Practice Address - Phone:405-343-1663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK586568225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist