=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326122771
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | USEN MASON DBA REALITY MEDICAL DISTRIBUTION AND SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2006
-----------------------------------------------------
Last Update Date | 09/30/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6633 HILLCROFT ST SUITE 139
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77081-4887
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-773-4280
-----------------------------------------------------
Fax | 713-773-4690
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6633 HILLCROFT ST SUITE 139
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77081-4887
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-773-4280
-----------------------------------------------------
Fax | 713-773-4690
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. USEN E. MASON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-773-4280
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 0091272
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------