Provider Demographics
NPI:1356874861
Name:KATES, COURTNEY LOUISE (MD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LOUISE
Last Name:KATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 BULL CREEK RD APT 4125
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-5965
Mailing Address - Country:US
Mailing Address - Phone:512-632-8670
Mailing Address - Fax:
Practice Address - Street 1:2203 W 35TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1203
Practice Address - Country:US
Practice Address - Phone:512-454-4731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT91452084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry