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NPI Code Detail

MEDICARE: MARK COUTURE D.P.M.

MEDICARE:   MARK  COUTURE  D.P.M.
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
1213ES0103XFoot & Ankle Surgery Podiatrist1651TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P00143574OTHERTXMEDICARE RAILROAD

Other Identifiers

General Provider Information

NPI Number : 1710981220
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK COUTURE D.P.M.
Provider Business Mailing Address
First Line : 7125 NEW SANGER ROAD
Second Line : SUITE 502
City : WACO
State : TX
Zip : 76712-4054
Country : US
Telephone Number : 254-732-2224
Fax Number : 254-732-2226
Provider Business Practice Location Address
First Line : 7125 NEW SANGER ROAD
Second Line : SUITE 502
City : WACO
State : TX
Zip : 76712-4054
Country : US
Telephone Number : 254-776-6995
Fax Number : 254-776-5577
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 03/07/2018

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Directions to “ MARK COUTURE D.P.M.” Practice Location

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