Provider Demographics
NPI:1073662714
Name:FLANAGAN, KATHY C (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:C
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 NORFOLK ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-4096
Mailing Address - Country:US
Mailing Address - Phone:713-528-1570
Mailing Address - Fax:713-528-5717
Practice Address - Street 1:2211 NORFOLK ST
Practice Address - Street 2:SUITE 505
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4096
Practice Address - Country:US
Practice Address - Phone:713-528-1570
Practice Address - Fax:713-528-5717
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH32132084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX71002176926Medicaid
TX71002176926Medicaid
TXE04522Medicare UPIN