Provider Demographics
NPI:1083113153
Name:STROOPE, MASON MURPHY (ATP)
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:MURPHY
Last Name:STROOPE
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:MR
Other - First Name:MURPHY
Other - Middle Name:
Other - Last Name:STROOPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ATP
Mailing Address - Street 1:8916 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-5124
Mailing Address - Country:US
Mailing Address - Phone:817-682-5579
Mailing Address - Fax:
Practice Address - Street 1:8916 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76140-5124
Practice Address - Country:US
Practice Address - Phone:817-682-5579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88819225CA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX213993OtherCOTA