Provider Demographics
NPI:1497738272
Name:KNEUPER, MARK FRENCH (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:FRENCH
Last Name:KNEUPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 NORTH HOUSTON
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4123
Mailing Address - Country:US
Mailing Address - Phone:830-625-6258
Mailing Address - Fax:830-629-6258
Practice Address - Street 1:652 NORTH HOUSTON
Practice Address - Street 2:SUITE 3
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4123
Practice Address - Country:US
Practice Address - Phone:830-625-6258
Practice Address - Fax:830-629-6258
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2511208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098690301Medicaid
TX020031592OtherRAILROAD MEDICARE
TX020031592OtherRAILROAD MEDICARE
TX0026AEMedicare ID - Type Unspecified