MEDICARE: MATTIE MARIE MASON RN, BSN

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	163WH0200X	Home Health Registered Nurse	249879	TX
2	171M00000X	Case Manager/Care Coordinator	249879	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1457379547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTIE MARIE MASON RN, BSN

Provider Business Mailing Address
First Line	:	18503 MILL PATH CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-5646
Country	:	US
Telephone Number	:	281-578-1205
Fax Number	:	281-578-9305

Provider Business Practice Location Address
First Line	:	18503 MILL PATH CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-5646
Country	:	US
Telephone Number	:	281-578-1205
Fax Number	:	281-578-9305

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	02/23/2026

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