Provider Demographics
NPI:1437670692
Name:COURSON, MARIA (OD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:COURSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:DUPRE-COURSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2401 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-2331
Mailing Address - Country:US
Mailing Address - Phone:409-886-2292
Mailing Address - Fax:409-883-8012
Practice Address - Street 1:9738 KATY FWY STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6214
Practice Address - Country:US
Practice Address - Phone:409-886-2292
Practice Address - Fax:409-883-8012
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9156TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist