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NPI Code Detail

MEDICARE: COURTNEY TREAT PA-C

MEDICARE: COURTNEY TREAT PA-C
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
1363AM0700XMedical Physician Assistant2018008248MO
2363LP0808XPsychiatric/Mental Health Nurse PractitionerPA12053TX
3363A00000XPhysician AssistantPA12053TX

General Provider Information

NPI Number : 1902308620
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY TREAT PA-C
Provider Business Mailing Address
First Line : 5795 BURNT RIDGE RD
Second Line :
City : SHIRLEY
State : AR
Zip : 72153-8313
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3824 N UNIVERSITY DR
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75965-2011
Country : US
Telephone Number : 936-558-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2018
Last Update Date : 04/25/2025

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Directions to “ COURTNEY TREAT PA-C” Practice Location

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