Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP110355 | TX |
NPI | 1003073750 |
---|---|
Provider Name | Ms. Martha E Flores |
First Address | Amarillo, TX 79109-1531 |
Second Address | Amarillo, TX 79121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 12/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3437113-01 | (05) | TX |