Provider Demographics
NPI:1730537895
Name:DWYER, KOURTNEY ANN (MD)
Entity type:Individual
Prefix:DR
First Name:KOURTNEY
Middle Name:ANN
Last Name:DWYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KOURTNEY
Other - Middle Name:ANN
Other - Last Name:APPLEGATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1850 LAKEPOINTE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3661
Mailing Address - Country:US
Mailing Address - Phone:972-436-5040
Mailing Address - Fax:
Practice Address - Street 1:2301 S FM 51 STE 300
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3864
Practice Address - Country:US
Practice Address - Phone:940-600-5799
Practice Address - Fax:940-600-5796
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS5365207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBP10057568OtherPHYSICIAN IN TRAINING PERMIT