Provider Demographics
NPI:1083678155
Name:MASON, DAVID PARK (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PARK
Last Name:MASON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1222 N BISHOP AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4176
Mailing Address - Country:US
Mailing Address - Phone:214-941-1353
Mailing Address - Fax:214-941-1047
Practice Address - Street 1:1222 N BISHOP AVE STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4176
Practice Address - Country:US
Practice Address - Phone:214-941-1353
Practice Address - Fax:214-941-1047
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0789208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2547882Medicaid
OH2547882Medicaid