Organization Active NPI

KFC Medical PLLC

  • Clinical Neuropsychologist
  • Plano, TX
National Provider Identifier
1215397294
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
J8977 Issued in TX
Legal business name
KFC MEDICAL PLLC
Practice address
5045 Lorimar Dr
Suite 290
Plano, TX 75093-5720
Phone
(972) 403-1463
Fax
(972) 403-1465
NPI assigned
Mar 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brian Flanagan, MDNPI 1962489930
Title
Manager
Phone
(214) 820-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X J8977 TX Primary

Addresses

Primary practice location

5045 Lorimar Dr
Suite 290
Plano, TX 75093-5720

Mailing address

PO Box 650444
Dept 121
Dallas, TX 75265-0444
Phone (972) 479-1115

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1215397294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650444",
            "address_2": "DEPT 121",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650444",
            "telephone_number": "972-479-1115",
            "fax_number": "972-479-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 LORIMAR DR",
            "address_2": "SUITE 290",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935720",
            "telephone_number": "972-403-1463",
            "fax_number": "972-403-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KFC MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "FLANAGAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-820-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "J8977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.