Provider Demographics
NPI:1790953164
Name:HENRY, COURTNEY WILLIAMS (PT, MS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:WILLIAMS
Last Name:HENRY
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17350 ST LUKES WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4103
Mailing Address - Country:US
Mailing Address - Phone:936-321-0333
Mailing Address - Fax:
Practice Address - Street 1:17350 ST LUKES WAY STE 100
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4103
Practice Address - Country:US
Practice Address - Phone:936-321-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1137008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist