Individual
DR. MARK GONZALES CUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
541 E SANDY LAKE RD, COPPELL, TX 75019-3090
(972) 393-3937
Mailing address
3412 TROWBRIDGE ST, FRISCO, TX 75036-8188
(317) 678-0572
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18003130A
IN
152W00000X
Optometrist
Primary
9965T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000351184
ANTHEM
IN
05
—
200402670A
—
IN
01
—
9965T
OPTOMETRY LICENSE
TX
01
—
P00190498
RAILROAD / TRAVELERS
IN
Enumeration date
01/13/2006
Last updated
04/30/2021
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