Provider Demographics
NPI:1407949613
Name:AIMONE, ROY JOHN (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:JOHN
Last Name:AIMONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 N LAURENT
Mailing Address - Street 2:SUITE A
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901
Mailing Address - Country:US
Mailing Address - Phone:361-578-3549
Mailing Address - Fax:361-578-4364
Practice Address - Street 1:4402 N LAURENT
Practice Address - Street 2:SUITE A
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901
Practice Address - Country:US
Practice Address - Phone:361-578-3549
Practice Address - Fax:361-578-4364
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6381207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033075501Medicaid
TX00EZ22Medicare ID - Type Unspecified
TX033075501Medicaid