Provider Demographics
NPI:1295795961
Name:FLORY, JENNIFER K (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:K
Last Name:FLORY
Suffix:
Gender:F
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:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7556 HONEYSUCKLE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-5631
Practice Address - Country:US
Practice Address - Phone:254-742-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7735207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1445736-03OtherCSHCN
TX1445736-01Medicaid
TX8B4702OtherBLUE SHIELD
TX080174139OtherRR/MEDICARE
TX1445736-03OtherCSHCN
TX8L23307Medicare PIN