Individual
COURTNEY DANIEL FAYRWEATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1635 NORTH LOOP W, HOUSTON, TX 77008-1532
(713) 867-2000
(713) 867-2099
Mailing address
12659 PINE BUSH DR, HOUSTON, TX 77070-4748
(281) 477-7784
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
660890
TX
363L00000X
Nurse Practitioner
Primary
AP113345
TX
363LF0000X
Family Nurse Practitioner
660890
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8Y0500
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/15/2007
Last updated
09/16/2024
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