Provider Demographics
NPI:1215038641
Name:MASKE, DAVID RAY (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RAY
Last Name:MASKE
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8637 FREDERICKSBURG RD STE 149
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1218
Mailing Address - Country:US
Mailing Address - Phone:210-828-3737
Mailing Address - Fax:210-614-5773
Practice Address - Street 1:8637 FREDERICKSBURG RD STE 149
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1218
Practice Address - Country:US
Practice Address - Phone:210-828-3737
Practice Address - Fax:210-614-5773
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6137111N00000X
TX2102111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU37890Medicare UPIN
TX603751Medicare ID - Type Unspecified