Provider Demographics
NPI:1437177862
Name:MASSON, JAMES LEE (DC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LEE
Last Name:MASSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 SOUTHEAST PARKWAY
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020
Mailing Address - Country:US
Mailing Address - Phone:817-237-2424
Mailing Address - Fax:817-428-8278
Practice Address - Street 1:1025 SOUTHEAST PARKWAY
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020
Practice Address - Country:US
Practice Address - Phone:817-237-2424
Practice Address - Fax:817-428-8278
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC2442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T14634Medicare UPIN
TX609575Medicare ID - Type Unspecified