Healthcare Provider Details

I. General information

NPI: 1952670390
Provider Name (Legal Business Name): FLYNN CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2011
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6573 OLD JACKSONVILLE HWY SUITE 100
TYLER TX
75703-0575
US

IV. Provider business mailing address

6573 OLD JACKSONVILLE HWY SUITE 100
TYLER TX
75703-0575
US

V. Phone/Fax

Practice location:
  • Phone: 903-617-6106
  • Fax: 903-617-6857
Mailing address:
  • Phone: 903-617-6106
  • Fax: 903-617-6857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10444
License Number StateTX

VIII. Authorized Official

Name: DR. DAVID C FLYNN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 903-617-6106