Healthcare Provider Details

I. General information

NPI: 1851488381
Provider Name (Legal Business Name): ROBIN MASON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MCCULLOUGH AVE
SAN ANTONIO TX
78215-1625
US

IV. Provider business mailing address

13000 VISTA DEL NORTE APT. 1323
SAN ANTONIO TX
78216-8038
US

V. Phone/Fax

Practice location:
  • Phone: 210-242-7505
  • Fax:
Mailing address:
  • Phone: 210-854-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number596279
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: