MEDICARE: DR. FLINT K DESHAZO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	H0291	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	080152577	OTHER	TX	FKD RRB MEDICARE UNIT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	86V632	OTHER	TX	FKD BLUE HMO
2	2930473005	OTHER	TX	FKD CIGNA HMO
3	86V632	OTHER	TX	FKS OLD HMO BLUE
5	7566001	OTHER	TX	FKD AETNA PPO
6	819464	OTHER	TX	FKD FH PPO
7	7566001	OTHER	TX	FKD AETNA HMO
8	86V632	OTHER	TX	FKD BLUE PPO
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	2930473006	OTHER	TX	FKD CIGNA PPO
11	742690907	OTHER	TX	FKD ST D PPO

General Provider Information

NPI Number	:	1669474623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FLINT K DESHAZO M.D.

Provider Business Mailing Address
First Line	:	7200 WYOMING SPGS
Second Line	:	STE 600
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4305
Country	:	US
Telephone Number	:	512-244-1995
Fax Number	:	512-244-2090

Provider Business Practice Location Address
First Line	:	7200 WYOMING SPGS
Second Line	:	STE 600
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4305
Country	:	US
Telephone Number	:	512-244-1995
Fax Number	:	877-215-6813

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	08/20/2025

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Directions to “ DR. FLINT K DESHAZO M.D.” Practice Location

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