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General NPI Number Information
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NPI Number | 1922062116
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Entity Type | Individual
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Provider Name | JOHN FLYNN TEICHGRAEBER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 6410 FANNIN ST SUITE 950
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City | HOUSTON
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State | TX
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Zip | 77030-3000
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Country | US
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Telephone | 832-325-7234
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Fax | 713-512-2221
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Provider Business Mailing Address
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Address Line | 6431 FANNIN ST MSB 5.254
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-500-7300
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Fax | 713-500-7296
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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 | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | G4061
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | G4061
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | G4061
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | G4061
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | G4061
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License Number State | TX
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