Provider Demographics
NPI:1487252441
Name:MCELROY, COURTNEY MARIE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:MARIE
Last Name:MCELROY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:COURTNEY
Other - Middle Name:MARIE
Other - Last Name:COLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2305 LONGMIRE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-7034
Mailing Address - Country:US
Mailing Address - Phone:936-293-8800
Mailing Address - Fax:
Practice Address - Street 1:2305 LONGMIRE DR STE 300
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-7034
Practice Address - Country:US
Practice Address - Phone:936-293-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1335862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1487252441.Medicaid