MEDICARE: MS. LETRICE K MASON NP

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	163WW0101X	Ambulatory Women's Health Care Registered Nurse	821405	TX
2	363LF0000X	Family Nurse Practitioner	AP33303	TX
3	363LF0000X	Family Nurse Practitioner	821405	TX
4	363LF0000X	Family Nurse Practitioner	AP133303	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

General Provider Information

NPI Number	:	1881140705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LETRICE K MASON NP

Provider Business Mailing Address
First Line	:	1622 W ALABAMA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4102
Country	:	US
Telephone Number	:	832-808-0903
Fax Number	:	832-553-7762

Provider Business Practice Location Address
First Line	:	1622 W ALABAMA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4102
Country	:	US
Telephone Number	:	832-808-0903
Fax Number	:	832-553-7762

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

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	07/25/2022

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