Provider Demographics
NPI:1093427478
Name:ROUND ROCK SQUARE HOLE PLLC
Entity Type:Organization
Organization Name:ROUND ROCK SQUARE HOLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:512-686-5578
Mailing Address - Street 1:1311 CHISHOLM TRAIL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2969
Mailing Address - Country:US
Mailing Address - Phone:512-686-5578
Mailing Address - Fax:
Practice Address - Street 1:1311 CHISHOLM TRAIL RD STE 103
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2969
Practice Address - Country:US
Practice Address - Phone:512-686-5578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty