Healthcare Provider Details

I. General information

NPI: 1003503194
Provider Name (Legal Business Name): MASON NIELSEN PRICE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N LINCOLN BLVD # 3400
OKLAHOMA CITY OK
73104-3252
US

IV. Provider business mailing address

2899 FM 934
ITASCA TX
76055-4800
US

V. Phone/Fax

Practice location:
  • Phone: 903-315-2000
  • Fax:
Mailing address:
  • Phone: 254-654-4376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number10083702
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: