1720825227 NPI number — JENNIFER MASON, MED, LPC, PLLC

Table of content: (NPI 1720825227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720825227 NPI number — JENNIFER MASON, MED, LPC, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JENNIFER MASON, MED, LPC, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720825227
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 OAK BEND TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIPAN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76462-4520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-544-2615
Provider Business Mailing Address Fax Number:
432-200-1882

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
203 W WALL ST STE 324
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79701-4509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
432-302-6338
Provider Business Practice Location Address Fax Number:
432-200-1882
Provider Enumeration Date:
07/11/2024

Additional Information

Authorized Official

Authorized Official Last Name:
MASON
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
PRACTICE OWNER AND SUPERVISOR
Authorized Official Telephone Number:
806-544-2615

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com