Provider Demographics
NPI:1962489930
Name:FLANAGAN, BRIAN KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:KEVIN
Last Name:FLANAGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 650444
Mailing Address - Street 2:DEPT 111
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0444
Mailing Address - Country:US
Mailing Address - Phone:972-972-4851
Mailing Address - Fax:972-556-5202
Practice Address - Street 1:12222 NORTH CENTRAL EXPRESSWAY
Practice Address - Street 2:SUITE 340
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3755
Practice Address - Country:US
Practice Address - Phone:972-972-4851
Practice Address - Fax:972-556-5202
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK1194208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043140503Medicaid
TX8D7600Medicare PIN
TX043140503Medicaid
TX8L0120Medicare PIN
TX8L0627Medicare PIN