MEDICARE: CHRISTINA MARIE MASON

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
1	101YM0800X	Mental Health Counselor	79862	TX

General Provider Information

NPI Number	:	1316600646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA MARIE MASON

Provider Business Mailing Address
First Line	:	17350 STATE HIGHWAY 249 STE 220
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77064-1132
Country	:	US
Telephone Number	:	512-669-1182
Fax Number	:

Provider Business Practice Location Address
First Line	:	4111 GREAT BEAR PL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-7973
Country	:	US
Telephone Number	:	512-669-1182
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2021
Last Update Date	:	10/13/2021

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Directions to “ CHRISTINA MARIE MASON ” Practice Location

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