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NPI Code Detail

MEDICARE: MASON FRIENDSWOOD OP LLC

MEDICARE: MASON FRIENDSWOOD OP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility132738TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2004286OTHERTXFACILITY ID

General Provider Information

NPI Number : 1225293855
Entity Type Code : Organization
Provider Name (Legal Business Name) : MASON FRIENDSWOOD OP LLC
Provider Business Mailing Address
First Line : 1500 SUNSET DR
Second Line :
City : FRIENDSWOOD
State : TX
Zip : 77546-4724
Country : US
Telephone Number : 281-992-4300
Fax Number : 281-992-0964
Provider Business Practice Location Address
First Line : 1500 SUNSET DR
Second Line :
City : FRIENDSWOOD
State : TX
Zip : 77546-4724
Country : US
Telephone Number : 281-992-4300
Fax Number : 281-992-0964
Authorized Official
Title or Position : ADMINISTRATOR
Name : JOHN BALLARD JR.
Credential :
Telephone Number : 281-992-4300
Provider Enumeration Date : 07/23/2008
Last Update Date : 08/02/2012

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Directions to “MASON FRIENDSWOOD OP LLC ” Practice Location

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