Provider Demographics
NPI:1972560399
Name:HAUGHT, COURTNEY A (MD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:A
Last Name:HAUGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3400 LONG PRAIRIE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2736
Mailing Address - Country:US
Mailing Address - Phone:972-899-6300
Mailing Address - Fax:972-899-6020
Practice Address - Street 1:3400 LONG PRAIRIE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2736
Practice Address - Country:US
Practice Address - Phone:972-899-6300
Practice Address - Fax:972-899-6020
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL3677207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH57129Medicare UPIN
TX00471WMedicare ID - Type UnspecifiedGROUP ID#