Provider Demographics
NPI:1144242173
Name:DUDLEY, COURTNEY RELYEA (MD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:RELYEA
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:DALE
Other - Last Name:RELYEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12174 N MO PAC EXPY STE A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2910
Mailing Address - Country:US
Mailing Address - Phone:512-833-7334
Mailing Address - Fax:512-833-7333
Practice Address - Street 1:12174 N MO PAC EXPY STE A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2910
Practice Address - Country:US
Practice Address - Phone:512-833-7334
Practice Address - Fax:512-833-7333
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4044208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics