Provider Demographics
NPI:1841662269
Name:FLOWERS, PAUL (ABO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:FLOWERS
Suffix:
Gender:M
Credentials:ABO
Other - Prefix:MRS
Other - First Name:SALEEMAH
Other - Middle Name:
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OPTICIAN
Mailing Address - Street 1:717 N UNION ST
Mailing Address - Street 2:SUIT #119
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-3031
Mailing Address - Country:US
Mailing Address - Phone:302-256-3239
Mailing Address - Fax:
Practice Address - Street 1:717 N UNION ST
Practice Address - Street 2:SUIT #119
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3031
Practice Address - Country:US
Practice Address - Phone:302-256-3239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-25
Last Update Date:2015-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FC0800X, 156FC0801X
DE156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter