Individual
COURTNEY KAY CLOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
7515 GREENVILLE AVE, SUITE 1030, DALLAS, TX 75231-3831
(214) 691-2111
(469) 916-8713
Mailing address
5060 ADDISON CIR APT 3835, ADDISON, TX 75001-6686
(940) 659-8286
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA05170
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217092003
—
TX
05
—
217092004
—
TX
05
—
217092005
—
TX
Enumeration date
03/06/2007
Last updated
08/22/2012
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