Individual
AMY R MCCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6901 MEDICAL PKWY, RADIOLOGY DEPARTMENT, WACO, TX 76712-7910
(903) 663-7393
(903) 663-7394
Mailing address
4777 US HIGHWAY 259, LONGVIEW, TX 75605-7668
(903) 663-7393
(903) 663-7394
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L1387
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151702101
—
TX
05
—
161422401
—
TX
01
—
8J0550
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/28/2006
Last updated
08/16/2013
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