Individual
KEVIN J FLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12201 RENFERT WAY STE 305, AUSTIN, TX 78758-5371
(512) 279-3376
(512) 540-8524
Mailing address
12201 RENFERT WAY STE 305, AUSTIN, TX 78758-5371
(512) 279-3376
(512) 666-3244
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
F1011
TX
207ND0900X
Dermatopathology Physician
F1011
TX
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
F1011
TX
207NP0225X
Pediatric Dermatology Physician
F1011
TX
207NS0135X
Procedural Dermatology Physician
F1011
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
F1011
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8B2644
BCBSTX
TX
01
—
8M7134
BCBS OF TEXAS INDIVIDUAL #
TX
Enumeration date
02/28/2006
Last updated
02/06/2019
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