Individual provider Active NPI

Eric Flesher, D.M.D.

  • Dentist
  • Conroe, TX
National Provider Identifier
1265814990
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31915 Issued in TX
Practice address
1403 N Loop 336 W Ste C
Conroe, TX 77304-3672
Phone
(936) 539-4867
NPI assigned
Jun 18, 2015
Last updated
Jul 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019-030178 IL
Dentist 122300000X 31915 TX Primary

Addresses

Primary practice location

1403 N Loop 336 W Ste C
Conroe, TX 77304-3672

Mailing address

2717 Bostwick St.
Alton, IL 62002-5412
Phone (847) 721-3532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-030178ILMDDentist
31915TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1265814990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 BOSTWICK ST.",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025412",
            "telephone_number": "847-721-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 N LOOP 336 W STE C",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043672",
            "telephone_number": "936-539-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLESHER",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-030178",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.