Provider Demographics
NPI:1104020767
Name:COURY, CAMERON L (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:L
Last Name:COURY
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 1:3005 E. RENNER ROAD
Mailing Address - Street 2:STE 100
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082
Mailing Address - Country:US
Mailing Address - Phone:972-699-0000
Mailing Address - Fax:972-699-0004
Practice Address - Street 1:3005 E. RENNER ROAD
Practice Address - Street 2:STE 100
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082
Practice Address - Country:US
Practice Address - Phone:972-699-0000
Practice Address - Fax:972-699-0004
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0022965207NP0225X
TXN3580207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2791935608OtherMYUTMB 2791935608-COMMERCIAL NUMBER