Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mark W Coburn, MD

Individual provider Diagnostic Radiology Physician · NPI 1811035694

Dr. Mark W Coburn, MD is a Diagnostic Radiology in Round Rock, Texas. Qualified in 1995, 31 years ago. Practices with Evergreen Radia LLC, a 116-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri, Texas and Washington.

Years since qualifying
31
Licensed in
MO, TX, WA
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

300 University Blvd
Round Rock, TX 78665-1032
Phone: (512) 509-0100
Fax: (512) 218-6330
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 203 S Western Ave, Tonasket, WA 98855-8803 — (509) 486-2151

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence N4357 (TX)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence MD61603753 (WA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 108365 (MO)

Record details

NPI number1811035694
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 2, 2007
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025
Mailing addressPo Box 844658, Dallas, TX 75284-4658

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Evergreen Radia Llc — 116 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations28 on file with Medicare

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