Provider Demographics
NPI:1679046197
Name:FLANIGAN, DENIS T (PHD)
Entity type:Individual
Prefix:DR
First Name:DENIS
Middle Name:T
Last Name:FLANIGAN
Suffix:
Gender:M
Credentials:PHD
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 STE 206
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-4030
Mailing Address - Country:US
Mailing Address - Phone:713-589-9804
Mailing Address - Fax:
Practice Address - Street 1:2211 NORFOLK ST STE 206
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4030
Practice Address - Country:US
Practice Address - Phone:713-589-9804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33415103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33415OtherTEXAS STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS