Provider Demographics
NPI:1093933871
Name:COWDEN, COURTNEY HOLT III (MD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:HOLT
Last Name:COWDEN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1314
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:3506 21ST ST
Practice Address - Street 2:STE 507
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1212
Practice Address - Country:US
Practice Address - Phone:806-725-4805
Practice Address - Fax:806-723-7076
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP1175207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FX315OtherBCBS TX
TX970223101OtherFIRSTCARE
TX324631602Medicaid
TX311084YKT8Medicare PIN