Provider Demographics
NPI:1811990716
Name:FLOURNOY, AIMEE L (MD)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:L
Last Name:FLOURNOY
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:AIMEE
Other - Middle Name:L
Other - Last Name:COKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:409 GLENWOOD ST # 500
Mailing Address - Street 2:
Mailing Address - City:GLEN ROSE
Mailing Address - State:TX
Mailing Address - Zip Code:76043-4933
Mailing Address - Country:US
Mailing Address - Phone:254-897-2202
Mailing Address - Fax:833-438-1469
Practice Address - Street 1:409 GLENWOOD ST # 500
Practice Address - Street 2:
Practice Address - City:GLEN ROSE
Practice Address - State:TX
Practice Address - Zip Code:76043-4933
Practice Address - Country:US
Practice Address - Phone:254-897-2202
Practice Address - Fax:833-438-1469
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1297207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152145201Medicaid
TX152145202Medicaid
TX8X8660OtherBCBS TX
TX2841700OtherAETNA
TX8X8660OtherBCBS TX
TX2841700OtherAETNA
TX00786TMedicare ID - Type Unspecified
TX8J5514Medicare PIN