Provider Demographics
NPI:1275730624
Name:ASH, COURTNEY WENDELL (PT)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:WENDELL
Last Name:ASH
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:WENDELL
Other - Last Name:BEVERIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1002 LOIRE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-1224
Mailing Address - Country:US
Mailing Address - Phone:832-581-4323
Mailing Address - Fax:832-581-4355
Practice Address - Street 1:3123 FM 1960 RD E STE 3123A
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5325
Practice Address - Country:US
Practice Address - Phone:832-581-4323
Practice Address - Fax:832-581-4355
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 009732225100000X
WV002123225100000X
TX1175853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH365496Medicaid