Individual
MARK COUTURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
7125 NEW SANGER ROAD, SUITE 502, WACO, TX 76712-4054
(254) 776-6995
(254) 776-5577
Mailing address
7125 NEW SANGER ROAD, SUITE 502, WACO, TX 76712-4054
(254) 732-2224
(254) 732-2226
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1651
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159939102
—
TX
01
—
169630401
MEDICAID OVER 21
TX
01
—
169630403
MEDICAID UNDER 21
TX
01
—
8M5110
BCBS
TX
01
—
P00143574
MEDICARE RAILROAD
TX
Enumeration date
06/13/2005
Last updated
03/07/2018
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