Basic Information
| Provider Information | |||||||||
| NPI: | 1205966819 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALDRIDGE | ||||||||
| FirstName: | COURTNEY | ||||||||
| MiddleName: | SPRAGUE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2317 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782982317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105586234 | ||||||||
| FaxNumber: | 2106151840 | ||||||||
| Practice Location | |||||||||
| Address1: | 9238 FLOYD CURL DR | ||||||||
| Address2: | STE 101 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782401690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105586234 | ||||||||
| FaxNumber: | 2106151840 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 08/16/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 03615 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.