Provider Demographics
NPI:1548672520
Name:MASON, KING JR (ND,)
Entity type:Individual
Prefix:DR
First Name:KING
Middle Name:
Last Name:MASON
Suffix:JR
Gender:M
Credentials:ND,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 F.M. 1960 ROAD WEST
Mailing Address - Street 2:#240
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068
Mailing Address - Country:US
Mailing Address - Phone:281-587-8191
Mailing Address - Fax:281-587-9591
Practice Address - Street 1:3920 F.M. 1960 ROAD WEST
Practice Address - Street 2:#240
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068
Practice Address - Country:US
Practice Address - Phone:281-587-8191
Practice Address - Fax:281-587-9591
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0106-0101NMD175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath