Healthcare Provider Details

I. General information

NPI: 1497109482
Provider Name (Legal Business Name): JOHN WESTON FLYNT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2016
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 GESSNER RD
HOUSTON TX
77024-2501
US

IV. Provider business mailing address

1323 W 23RD ST
HOUSTON TX
77008-1609
US

V. Phone/Fax

Practice location:
  • Phone: 713-222-2273
  • Fax:
Mailing address:
  • Phone: 713-397-3882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number299940
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberU2488
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number299940
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberU2488
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberU2488
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: