Provider Demographics
NPI:1952315137
Name:FLACK, JAMES N (M D)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:N
Last Name:FLACK
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 GESSNER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-2503
Mailing Address - Country:US
Mailing Address - Phone:713-275-5086
Mailing Address - Fax:713-275-5107
Practice Address - Street 1:2801 GESSNER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-2503
Practice Address - Country:US
Practice Address - Phone:713-275-5086
Practice Address - Fax:713-275-5107
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH35662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L6976Medicare PIN