Provider Demographics
NPI:1083041024
Name:MASON, ANDREA (RN)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2378 E LEDBETTER DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7410
Mailing Address - Country:US
Mailing Address - Phone:469-658-6437
Mailing Address - Fax:800-985-7801
Practice Address - Street 1:1700 COMMERCE ST
Practice Address - Street 2:SUITE 660
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-5314
Practice Address - Country:US
Practice Address - Phone:800-985-7801
Practice Address - Fax:800-985-7801
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-05
Last Update Date:2013-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator