Provider Demographics
NPI:1922863059
Name:FLANNAGAN, RODNEY (EMT ADVANCED)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:
Last Name:FLANNAGAN
Suffix:
Gender:M
Credentials:EMT ADVANCED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W THOMPSON ST APT 145
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-2466
Mailing Address - Country:US
Mailing Address - Phone:832-628-1276
Mailing Address - Fax:
Practice Address - Street 1:1821 S FM 51
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3715
Practice Address - Country:US
Practice Address - Phone:940-233-6929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31179146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Multi-Specialty