Provider Demographics
NPI:1639466089
Name:ALLEN, COURTNEY BAYER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:BAYER
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 ARBOR TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6357
Mailing Address - Country:US
Mailing Address - Phone:214-476-3311
Mailing Address - Fax:
Practice Address - Street 1:9109 ARBOR TRAIL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6357
Practice Address - Country:US
Practice Address - Phone:214-476-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1206476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX874T73OtherBLUE CROSS BLUE SHIELD OF TEXAS