Provider Demographics
NPI:1487692869
Name:COURTRIGHT, JAY GORDON (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:GORDON
Last Name:COURTRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:BLDG D, SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-7790
Practice Address - Fax:972-566-5819
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6848207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159932601Medicaid
TX159932602Medicaid
TX159932603Medicaid
TX8R1418OtherBLUE CROSS OF TEXAS
TX159932601Medicaid
TX8D9686Medicare PIN
TXTXB126027Medicare PIN
TX159932603Medicaid
TX159932602Medicaid