MEDICARE: DR. COURTNEY ANN LANDRY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	N0198	TX
2	207P00000X	Emergency Medicine Physician	N0198	TX

General Provider Information

NPI Number	:	1871583500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COURTNEY ANN LANDRY M.D.

Provider Business Mailing Address
First Line	:	1415 MEADOW BAY CT
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4058
Country	:	US
Telephone Number	:	504-453-8411
Fax Number	:

Provider Business Practice Location Address
First Line	:	6840 HIGHWAY 6
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3850
Country	:	US
Telephone Number	:	281-403-3660
Fax Number	:	281-403-4718

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/03/2012

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Directions to “ DR. COURTNEY ANN LANDRY M.D.” Practice Location

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