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NPI Code Detail

MEDICARE: MASTOR LANGSTON

MEDICARE:   MASTOR  LANGSTON
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1679012702
Entity Type Code : Individual
Provider Name (Legal Business Name) : MASTOR LANGSTON
Provider Business Mailing Address
First Line : 900 DOOLITTLE AVE
Second Line : APT 216
City : LAS VEGAS
State : NV
Zip : 89106-2590
Country : US
Telephone Number : 702-576-5917
Fax Number :
Provider Business Practice Location Address
First Line : 900 DOOLITTLE AVE
Second Line : APT 216
City : LAS VEGAS
State : NV
Zip : 89106-2590
Country : US
Telephone Number : 702-576-5917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2017
Last Update Date : 02/22/2017

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Directions to “ MASTOR LANGSTON ” Practice Location

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