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NPI Code Detail

MEDICARE: DR. STACIE LYNN FLANERY D.C.

MEDICARE: DR. STACIE LYNN FLANERY D.C.
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
1111N00000XChiropractor9158TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1606357OTHERTXBLUE CROSS BLUE SHIELD
247-0868164OTHERTXEMPLOYER ID

General Provider Information

NPI Number : 1699898502
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STACIE LYNN FLANERY D.C.
Provider Business Mailing Address
First Line : 120 TRINITY CT
Second Line :
City : COPPELL
State : TX
Zip : 75019-4309
Country : US
Telephone Number : 144-029-6422
Fax Number :
Provider Business Practice Location Address
First Line : 3100 SWISS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75204-6025
Country : US
Telephone Number : 469-291-9129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 04/29/2019

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