Provider Demographics
NPI:1194243717
Name:EDDINS, COURTENAY A
Entity type:Individual
Prefix:MS
First Name:COURTENAY
Middle Name:A
Last Name:EDDINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:COURTENAY
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16501 VESCOVO LN
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4280
Mailing Address - Country:US
Mailing Address - Phone:501-920-8845
Mailing Address - Fax:
Practice Address - Street 1:4000 S. I-H 35 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704
Practice Address - Country:US
Practice Address - Phone:512-414-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-04
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122116225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist