Provider Demographics
NPI:1871114454
Name:NIXON, COURTNEY B (RSPS)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:B
Last Name:NIXON
Suffix:
Gender:F
Credentials:RSPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4518 PRINCE PINE TRL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3124
Mailing Address - Country:US
Mailing Address - Phone:512-541-0876
Mailing Address - Fax:
Practice Address - Street 1:1013 DELESANDRI LN
Practice Address - Street 2:
Practice Address - City:KEMAH
Practice Address - State:TX
Practice Address - Zip Code:77565-3142
Practice Address - Country:US
Practice Address - Phone:512-541-0876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1203-0420175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist