Provider Demographics
NPI:1467920876
Name:HAMILTON, COURTNEY (RD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 WOODHOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-4311
Mailing Address - Country:US
Mailing Address - Phone:303-218-0259
Mailing Address - Fax:
Practice Address - Street 1:2800 SHORELINE DR STE 120
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0130
Practice Address - Country:US
Practice Address - Phone:855-383-1240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84842133VN1004X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric