Provider Demographics
NPI:1881158525
Name:DR. TUERE COULTER, PLLC
Entity type:Organization
Organization Name:DR. TUERE COULTER, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TUERE
Authorized Official - Middle Name:
Authorized Official - Last Name:COULTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-478-2780
Mailing Address - Street 1:6108 NORWOOD MILLS CT
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6483
Mailing Address - Country:US
Mailing Address - Phone:678-478-2780
Mailing Address - Fax:
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
Practice Address - Country:US
Practice Address - Phone:678-478-2780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. TUERE COULTER, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-28
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center