Provider Demographics
NPI:1427553593
Name:BAUS, COURTNEY JEWEL
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JEWEL
Last Name:BAUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 E 45TH ST APT 11
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3229
Mailing Address - Country:US
Mailing Address - Phone:956-207-4680
Mailing Address - Fax:
Practice Address - Street 1:611 E 45TH ST APT 11
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-3229
Practice Address - Country:US
Practice Address - Phone:956-207-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program