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General NPI Number Information
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NPI Number | 1689640633
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Entity Type | Individual
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Provider Name | KEVIN J FLYNN MD
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Gender | Male
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 12201 RENFERT WAY STE 305
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City | AUSTIN
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State | TX
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Zip | 78758-5371
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Country | US
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Telephone | 512-279-3376
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Fax | 512-540-8524
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Provider Business Mailing Address
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Address Line | 12201 RENFERT WAY STE 305
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City | AUSTIN
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State | TX
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Zip | 78758-5371
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Country | US
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Telephone | 512-279-3376
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Fax | 512-666-3244
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | F1011
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207NI0002X
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Taxonomy Name | Clinical & Laboratory Dermatological Immunology Physician
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License Number | F1011
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | F1011
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | F1011
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | F1011
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | F1011
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License Number State | TX
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