Active NPI
William Eugene Flynn, PHD
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1750476040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 21400
- Practice address
- 100 Highland Park Village
Suite 200
Dallas, TX 75205 - Phone
- (214) 202-7344
- Fax
- (214) 902-1766
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 21400 | TX | Primary |
| Forensic Psychologist | 103TF0200X | 21400 | TX |
Addresses
Primary practice location
100 Highland Park Village
Suite 200
Dallas, TX 75205
Mailing address
100 Highland Park Village
Suite 200
Dallas, TX 75205
Phone (214) 202-7344
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00JT29 | Other | TX | BCBS |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21400 | TX | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1750476040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HIGHLAND PARK VILLAGE",
"address_2": "SUITE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "75205",
"telephone_number": "214-202-7344",
"fax_number": "214-902-1766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HIGHLAND PARK VILLAGE",
"address_2": "SUITE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "75205",
"telephone_number": "214-202-7344",
"fax_number": "214-902-1766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "WILLIAM",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "21400",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "TX",
"license": "21400",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00JT29",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.