Provider Demographics
NPI:1710142880
Name:COULTER, TUERE SARAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TUERE
Middle Name:SARAN
Last Name:COULTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12568 BROADWAY ST STE 160
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8948
Mailing Address - Country:US
Mailing Address - Phone:832-619-1669
Mailing Address - Fax:760-267-9223
Practice Address - Street 1:12568 BROADWAY ST STE 160
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8948
Practice Address - Country:US
Practice Address - Phone:832-619-1669
Practice Address - Fax:760-267-9223
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.125545207Q00000X
TXBP10028672207Q00000X
TXN6235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX288999001Medicaid
TXTXB137103Medicare PIN