Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | L7789 | TX |
Y | 207XS0117X | Orthopaedic Spine Surgeon | L7789 | TX |
NPI | 1013069780 |
---|---|
Provider Name | Dr. Mark P Kuper |
First Address | Fort Worth, TX 76132-3119 |
Second Address | Fort Worth, TX 76132-3119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 02/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I20936 | (02) | TX |