Provider Demographics
NPI:1467074443
Name:BIRKESTRAND, CORY DANIEL (DO, MA)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:DANIEL
Last Name:BIRKESTRAND
Suffix:
Gender:M
Credentials:DO, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22999 HIGHWAY 59 N
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-4412
Mailing Address - Country:US
Mailing Address - Phone:281-348-3320
Mailing Address - Fax:
Practice Address - Street 1:22999 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-4412
Practice Address - Country:US
Practice Address - Phone:281-348-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT7497207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine