Individual
DR. MARK W COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0100
(512) 218-6330
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
108365
MO
2085R0202X
Diagnostic Radiology Physician
MD61603753
WA
2085R0202X
Diagnostic Radiology Physician
Primary
N4357
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140791001
—
AR
01
—
173098
MO BLUE SHIELD
MO
05
—
205007503
—
MO
01
—
98569
ARK BLUE SHIELD
AR
Enumeration date
02/02/2007
Last updated
12/04/2025
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